Two Cases of Bowel Necrosis During Enteral Nutrition after Abdominal Surgery

術後早期の経腸栄養に関連する致死的合併症の一つとして，腸管壊死の報告が散見されていることはあまり知られていない．今回，我々は腹部手術後の経腸栄養使用中に腸管壊死を発症した2例を経験したので報告する．症例1は乳頭部癌の77歳女性で膵頭十二指腸切除術を施行し，14病日に門脈出血に対し緊急止血術を施行した．緊急手術から8日目より半消化態製剤による経腸栄養投与を開始した．経腸栄養を開始してから14日目に腸管壊死を発症し大量腸切除を行った．症例2は再発胃癌の79歳女性で残胃全摘後に4病日より半消化態製剤による経腸栄養投与を開始したところ，6病日に腸管壊死を発症し大量腸切除を行った．2例とも手術により救命しえた．経腸栄養が関与したと推測される腸管壊死は，欧米を中心に症例報告が散見されており，自験2例を含めた文献的考察を交えて報告する．

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