Abstract:
The ingestion of corrosive industrial chemical agents, such as caustic soda, that are mostly used for household cleaning, usually occurs accidentally or for suicidal purposes. Multiple protocols are based on documented success in preventing impending complications. In this study, we present a case of a 70-year-old man who swallowed caustic soda in a suicide attempt, causing a development of strong esophageal and gastric necrosis with subsequent gastrectomy and digiunostomy. Initially, the recommended nutritional approach was via percutaneous endoscopic jejunostomy by a polymer and high-caloric formula, with an elevated content of soluble fiber. After 5 months, the medical team removed the percutaneous endoscopic jejunostomy and the patient switched from enteral to oral nutrition. In this step, it was decided to introduce two oral, high-caloric supplements: an energy supplement in powder, based on maltodextrin, immediately soluble in foods or in hot/cold drinks and a high-energy and protein drink, enriched with arginine, vitamin C, zinc, and antioxidants. Oral administration (per os) was well tolerated by consuming homogenized food mixed in water. After 1 month, the patient was discharged from the hospital and was able to eat a regular meal.
摘要:
腐蚀性工业化学试剂的摄入,如苛性钠,主要用于家庭清洁,通常是偶然发生或出于自杀目的。多种方案基于防止即将发生的并发症的成功记录。在这项研究中,我们介绍了一个70岁的男子,他吞下苛性钠企图自杀,导致严重的食管和胃坏死,随后进行胃切除术和数字造口术。最初,推荐的营养方法是通过聚合物和高热量配方经皮内镜空肠造口术,可溶性纤维含量升高。5个月后,医疗团队移除了经皮内镜空肠造口术,患者从肠内营养转为口服营养。在这一步,决定引入两个口头,高热量补充剂:粉末中的能量补充剂,基于麦芽糊精,立即溶于食物或热/冷饮料和高能量和蛋白质饮料,富含精氨酸,维生素C,锌,和抗氧化剂。通过食用混合在水中的均质化食物,口服给药(每个操作系统)具有良好的耐受性。一个月后,病人出院了,能够正常吃饭。