Aortoenteric fistulas: Is there a place for parenteral nutrition?

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/m 2 (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.

Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report

“…Continued nutritional support is essential in the postoperative course, but a feeding jejonostomy or gastrostomy is not recommended at least during the first five to seven post-operative days due to potential complications related to tube enterostomies. The use of parenteral nutrition is a method to support the nutritional status if the anticipated prolonged absence of oral food intake [ 10 ].…”