Liver disease due to parenteral and enteral nutrition

Kwan, Vu; George, Josh

doi:10.1016/j.cld.2004.06.003

Cited by 24 publications

(8 citation statements)

References 101 publications

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“…Liver dysfunction is fairly common, occurring in 15%-40% of adults receiving home PN. 4,18 This patient likely experienced this complication, as substantiated by the significant increase in serum concentrations of AP, GGT, and T bilirubin, as well as the onset of hepatosplenomegaly, coinciding with PN administration (consistent with acute fatty liver with necrosis).…”

Section: Discussionmentioning

confidence: 93%

Fistuloclysis: Case Report and Literature Review

2007

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Enterocutaneous fistulae are a common postoperative entity, causing serious complications such as sepsis, malnutrition, and electrolyte and fluid abnormalities. Because sepsis coupled with malnutrition is the leading cause of death in these patients, it is especially important to provide nutrition support. Although parenteral nutrition (PN) is widely used in these patients, it is not without risks, because PN is known to cause liver dysfunction, among other problems. We report a case in which a male patient with an enterocutaneous fistula, having experienced increased liver enzymes receiving PN, began receiving enteral nutrition (EN) via a feeding tube placed in the fistula. Known as fistuloclysis, this method provided adequate nutrition and improved his serum albumin and prealbumin levels, body weight, and liver function tests. Upon stabilization of his nutrition status, he was able to undergo successful surgical repair of the enterocutaneous fistula. According to our experience and that of others, we recommend that patients with high-output enterocutaneous fistulae be considered for EN via fistuloclysis after nutrition stabilization with PN; then the fistulae can be surgically repaired if not spontaneously healed. Use of EN via fistuloclysis, if used appropriately, avoids the complications of long-term PN and may promote faster fistula healing.

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Section: Discussionmentioning

confidence: 93%

Fistuloclysis: Case Report and Literature Review

2007

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“…However, PN has many potential complications, including acute liver dysfunction, atrophy of intestinal villus, bacteria translocation, catheter-related infections, and hyperglycemia. Specifically, liver dysfunction is fairly common, occurring in 15%–40% of patients [18]. Moreover, PN is expensive and highly demanding of professional nursing care.…”

Section: Discussionmentioning

confidence: 99%

Fistuloclysis Improves Liver Function and Nutritional Status in Patients with High-Output Upper Enteric Fistula

Ren

Wang

et al. 2014

Gastroenterology Research and Practice

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Background. We aimed to determine the efficacy of fistuloclysis in patients with high-output upper enteric fistula (EF). Methods. Patients were assigned into the fistuloclysis group (n = 35, receiving fistuloclysis plus total enteral nutrition (TEN)) and the control group (n = 60, receiving TEN). Laboratory variables were measured during the four-week treatment. Results. At baseline, variables were similar between the two groups. Delta value was defined as the changes from baseline to day 28. Compared with the control group, the fistuloclysis group showed greater improvements in liver function (Delta total bilirubin (TB): 20.3 ± 9.7 in the fistuloclysis group versus 15.6 ± 6.3 in the control group, P = 0.040; Delta direct bilirubin (DB): 12.5 ± 3.4 versus 10.0 ± 3.6, P = 0.011; Delta alkaline phosphatase (ALP): 98.4 ± 33.5 versus 57.6 ± 20.9, P < 0.001); nutritional status (Delta total protein: 21.8 ± 8.7 versus 10.7 ± 2.1, P < 0.001; Delta albumin: 11.3 ± 2.5 versus 4.2 ± 1.3, P < 0.001). In the fistuloclysis subgroups, biliary fistula patients had the maximum number of variables with the greatest improvements. Conclusions. Fistuloclysis improved hepatic and nutritional parameters in patients with high-output upper EF, particularly in biliary fistula patients.

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“…Biliary sludge has been shown to be present in all patients within 6 weeks of starting PN [ 56 , 58 ]. Gallstones, which become evident after about 4 months of PN, are generally pigment stones [ 61 ]. Both calculous and acalculous cholecystitis have been reported.…”

Section: Extrahepatic Complicationsmentioning

confidence: 99%

Cholestasis in the Hospitalized Patient

Larson

2014

Clinical Gastroenterology

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Liver disease due to parenteral and enteral nutrition

Cited by 24 publications

References 101 publications

Fistuloclysis: Case Report and Literature Review

Fistuloclysis: Case Report and Literature Review

Fistuloclysis Improves Liver Function and Nutritional Status in Patients with High-Output Upper Enteric Fistula

Cholestasis in the Hospitalized Patient

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