Aortoenteric fistulas: Is there a place for parenteral nutrition?

Authors


  • I. Kotsikoris, MD, MSc, Resident (Vascular Surgery)

  • A. Zygomalas, MD, MSc, Resident (General Surgery)

  • D. Maras, MD, Clinical Director (Vascular Surgery)

  • T. Papas, MD, PhD, Consultant (Vascular Surgery)

  • M. Andrikopoulou, MD, Resident (Vascular Surgery)

  • V. Alivizatos, MD, PhD, Clinical Director (General Surgery-Artificial Nutrition Unit)

  • N. Bessias, MD, Clinical Director (Vascular Surgery)

  • The authors have no conflict of interest. This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. All authors have made substantial contributions to the conception and design of the study, acquisition of data, analysis and interpretation of data.

A. Zygomalas, Theodotou 27, 26442 Patras, Greece. Email: azygomalas@upatras.gr

Abstract

Aim:  Aortoenteric fistulas are a rare but often fatal cause of gastrointestinal bleeding. Operative repair has been historically associated with extremely high morbidity and mortality. From the literature and our own experience, the mean overall length of stay for patients who are successfully discharged from the hospital appears to be more than 15 days, and oral feeding is frequently delayed. Possibilities of nutritional intervention in vascular surgery patients are important. The aim of this study was to evaluate the use of parenteral nutrition in patients treated for aortoenteric fistulas.

Methods:  The records of all patients admitted to the Department of Vascular Surgery with AEFs during the last three years (2007–2009) were reviewed and analysed.

Results:  During the last three years, five patients were admitted to the Department of Vascular Surgery with AEFs. Their mean age was 55.8 years (range 49–67). Four patients were male and one was female. The mean body mass index was 28.6 kg/m2 (range 25 to 33.2). The Malnutrition Universal Screening Tool score showed a high risk for malnutrition for all the patients. The mean hospital stay was 25.2 days. All five patients were supported with total PN (four central and one peripheral). There were no complications due to PN.

Conclusion:  Provision of PN support in patients with AEFs may be used without complications.

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