Successful Management of Salt and Water Depletion for Jejunostomy Patient Using Saline for the Solution of the Elemental Diet: Report of A Case

概要

論文の詳細を見る
An 81-year-old woman admitted for epigastralgia, and the angiography revealed occulusion of the superior mesenteric artery by thrombus. The operative findings showed massive bowel necrosis. Extensive bowel resection and jejuno-colic anastomosis was performed. The remaining length of the jejunum was 50cm. Postoperatively a major leakage of the anastomosis occurred, so an end-jejunostomy was performed. Patients with a jejunostomy have major problems with undernutrition, dehydration, and sodium depletion due to the large volume of stomal output. During the replacement of the total parenteral nutrition with enteral nutrition, the reduction of the parenteral saline supply or the increase of the enteral nutrition caused hyponatremia and hypochloremia. Using saline for the solution of the elemental diet, we could replace the parenteral nutrition with the enteral nutrition and peroral nutrition without electrolyte depletion. The elemental diet probably promotes dehydration, however, because of its hyperosmolality. Patients such as ours thus still need a parenteral saline supply
一般社団法人日本消化器外科学会の論文