BACKGROUND Gastrointestinal(GI)tract injuries and defects form a heterogeneous group of conditions often presenting with fistula formation.Management depends on factors such as defect number,anatomical location,and pa...BACKGROUND Gastrointestinal(GI)tract injuries and defects form a heterogeneous group of conditions often presenting with fistula formation.Management depends on factors such as defect number,anatomical location,and patient status,requiring a therapy that addresses multiple etiopathogenic factors.CASE SUMMARY We present two cases of patients who underwent total gastrectomy for gastric malignancy.A combined therapeutic approach was employed,based on isolating the injury site with local vacuum-assisted closure(VAC)therapy and simultaneous enteral nutrition.This method facilitated successful healing and enabled the identification of previously undetected defects not recognized by conventional diagnostics.CONCLUSION The combination of injury site isolation,local VAC therapy,and enteral feeding proved to be safe,effective,and easily adaptable to standard surgical practice.This approach may expand surgical options in the treatment of GI tract injuries and defects.展开更多
BACKGROUND Early initiation of enteral feeding is recognized to play a crucial role in improving the outcomes of treatment of acute pancreatitis.However,the method of adminis-tration of enteral nutrition remains debat...BACKGROUND Early initiation of enteral feeding is recognized to play a crucial role in improving the outcomes of treatment of acute pancreatitis.However,the method of adminis-tration of enteral nutrition remains debatable.We present the experience of treating a patient with moderate-severe acute pancreatitis,at high risk of progressing to a severe or fatal condition,using a novel method of selective feeding with duodenal isolation.CASE SUMMARY A 27-year-old female patient presented to the emergency unit of the hospital with a typical manifestation of acute pancreatitis.Despite a conventional treatment,the patient’s condition deteriorated by day 2 of hospitalization.Using an endoscopic approach,a novel catheter PandiCathffwas placed to the duodenum of the patient,isolating its segment between the duodenal bulb and the ligament of Treitz.In the isolated area created,a negative pressure was applied,followed by introduction of early selective enteral feeding.The patient’s condition subsequently improved in a rapid manner,and no complications often associated with moderate-to-severe acute pancreatitis developed.CONCLUSION Within 48 h of starting treatment with the novel method,it can prevent the development of multiple organ failure and,when combined with minimally invasive drainage methods,help prevent infection.展开更多
文摘BACKGROUND Gastrointestinal(GI)tract injuries and defects form a heterogeneous group of conditions often presenting with fistula formation.Management depends on factors such as defect number,anatomical location,and patient status,requiring a therapy that addresses multiple etiopathogenic factors.CASE SUMMARY We present two cases of patients who underwent total gastrectomy for gastric malignancy.A combined therapeutic approach was employed,based on isolating the injury site with local vacuum-assisted closure(VAC)therapy and simultaneous enteral nutrition.This method facilitated successful healing and enabled the identification of previously undetected defects not recognized by conventional diagnostics.CONCLUSION The combination of injury site isolation,local VAC therapy,and enteral feeding proved to be safe,effective,and easily adaptable to standard surgical practice.This approach may expand surgical options in the treatment of GI tract injuries and defects.
文摘BACKGROUND Early initiation of enteral feeding is recognized to play a crucial role in improving the outcomes of treatment of acute pancreatitis.However,the method of adminis-tration of enteral nutrition remains debatable.We present the experience of treating a patient with moderate-severe acute pancreatitis,at high risk of progressing to a severe or fatal condition,using a novel method of selective feeding with duodenal isolation.CASE SUMMARY A 27-year-old female patient presented to the emergency unit of the hospital with a typical manifestation of acute pancreatitis.Despite a conventional treatment,the patient’s condition deteriorated by day 2 of hospitalization.Using an endoscopic approach,a novel catheter PandiCathffwas placed to the duodenum of the patient,isolating its segment between the duodenal bulb and the ligament of Treitz.In the isolated area created,a negative pressure was applied,followed by introduction of early selective enteral feeding.The patient’s condition subsequently improved in a rapid manner,and no complications often associated with moderate-to-severe acute pancreatitis developed.CONCLUSION Within 48 h of starting treatment with the novel method,it can prevent the development of multiple organ failure and,when combined with minimally invasive drainage methods,help prevent infection.
