Gastrointestinal obstruction caused by solidification and coagulation of enteral nutrition: pathogenetic mechanisms and potential risk factors

Enteral nutrition (EN) is preferred in order to provide nutrition and reduce catabolism in critically ill patients. Recent studies suggest that the use of EN is successful and complications are rare. However, an underestimated mechanical complication of tube feedings seen in critically ill patients is the coagulation and solidification of the EN causing gastrointestinal obstruction. This report describes two clinical cases (1.23% of all cases seen at our clinic) of obstruction and perforation of the small bowel secondary to the solidification of EN. The understanding and early recognition of this potential complication are essential for the prevention and successful treatment of this condition.

[1]  H. Rijna,et al.  Gastrointestinal obstruction by solidification of enteral nutrition: a result of impaired digestion in critically ill patients , 2013 .

[2]  Jennifer Childers,et al.  Small bowel necrosis in association with jejunal tube feeding. , 2010, JAAPA : official journal of the American Academy of Physician Assistants.

[3]  A. Caldeira,et al.  [Enteric nutrition and esophageal impactation: what relationship]. , 2010, Acta medica portuguesa.

[4]  K. Verbeke,et al.  Gastric emptying in healthy newborns fed an intact protein formula, a partially and an extensively hydrolysed formula. , 2008, Clinical nutrition.

[5]  M. Schäfer,et al.  Postoperative bezoar ileus after early enteral feeding , 2007, Journal of Gastrointestinal Surgery.

[6]  A. Fichera,et al.  Bowel necrosis associated with early jejunal tube feeding: A complication of postoperative enteral nutrition. , 2006, Archives of surgery.

[7]  N. Halkic,et al.  Small-bowel perforation: a consequence of feeding jejunostomy. , 2005, Canadian journal of surgery. Journal canadien de chirurgie.

[8]  D. Heyland,et al.  Optimizing the benefits and minimizing the risks of enteral nutrition in the critically ill: role of small bowel feeding. , 2002, JPEN. Journal of parenteral and enteral nutrition.

[9]  J. Saffle,et al.  Intestinal obstruction secondary to enteral feedings in burn trauma patients. , 1999, The Journal of trauma.

[10]  R. Malthaner,et al.  Small-bowel necrosis associated with jejunal tube feeding. , 1998, Canadian journal of surgery. Journal canadien de chirurgie.

[11]  L. Flint,et al.  Small bowel necrosis in association with jejunostomy tube feedings. , 1996, The American surgeon.

[12]  J. Daly,et al.  Small bowel necrosis associated with postoperative jejunal tube feeding. , 1995, Journal of the American College of Surgeons.

[13]  S. Curtas,et al.  Intestinal obstruction from cecal bezoar; a complication of fiber-containing tube feedings. , 1990, Nutrition.

[14]  R. Schreiner,et al.  Lack of lactobezoars in infants given predominantly whey protein formulas. , 1982, American journal of diseases of children.