Système gastro-intestinal et digestif

Abstrait

Enteral Nutrition Support in Patients with Pyloric Obstruction

Yuanfan Yang Jianchun Yu, Weiming Kang, and Yan Li

Pyloric obstruction is a common clinical diagnosis in Asian countries because there is a higher incidence of gastric cancer in the population. Patients, especially in rural areas, present to hospital late when gastric outlet obstruction has become so severe that oral feeding is almost impossible. Each hospital has developed its own method of feeding to provide nutritional support for these patients before pyloric obstruction is relieved, usually by surgery. Until recently, most hospitals use parenteral nutrition (PN), which requires less effort in setting access route. However both ESPEN and the Chinese guideline would recommend post pyloric enteral nutrition (EN) for patients with a partially functional GI tract, as EN has been demonstrated to be safer, cheaper and associated with less metabolic complications. Setting a safe and convenient route for post-pyloric feeding requires a more dedicated team and solid protocol. Here we report the EN support for 3 patients with pyloric obstruction in June 2013, utilizing the combination nasogastric decompression-nasojejunal feeding tube system. An additional paragraph is given to nutrition evaluation, nursing care of the feeding system, and trouble shooting.