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Nutritional management in an elderly man with esophageal and gastric necrosis after caustic soda ingestion: a case report

机译:烧碱摄入后一名食管和胃坏死的老人的营养管理:一例报告

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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.
机译:摄入主要用于家庭清洁的腐蚀性工业化学试剂(例如苛性钠),通常是偶然发生或出于自杀目的。多种协议基于已记录的成功预防并发症的成功。在这项研究中,我们提出了一例70岁的男子自杀企图吞下烧碱,导致强烈的食道和胃坏死的发展,随后进行了胃切除术和数字吻合术。最初,推荐的营养方法是通过聚合物和高热量配方的经皮内镜空肠造口术,同时增加可溶性纤维的含量。 5个月后,医疗团队撤去了经皮内镜空肠造口术,患者从肠内营养改为口服营养。在这一步骤中,决定引入两种口服高热量补充剂:一种基于麦芽糊精的粉末状能量补充剂,可立即溶于食品或热/冷饮料中;一种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食物,可以很好地耐受口服(口服)。 1个月后,患者出院,可以吃顿饭。

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