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Parenteral nutrition in pancreatitis

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https://www.readbyqxmd.com/read/29150368/the-utility-of-ercp-in-pediatric-pancreatic-trauma
#1
Eric H Rosenfeld, Adam M Vogel, Denise B Klinkner, Mauricio Escobar, Barbara Gaines, Robert Russell, Brendan Campbell, Hale Wills, Anthony Stallion, David Juang, Rajan K Thakkar, Jeffrey Upperman, Mubeen Jafri, Randall Burd, Bindi J Naik-Mathuria
BACKGROUND/PURPOSE: Endoscopic retrograde cholangiopancreatography (ERCP) is an adjunct for pediatric pancreatic injury management, but its use and utility in pediatric patients are unclear. We set out to evaluate the use of ERCP and its effects on outcomes. METHODS: A retrospective review was performed for children who had pancreatic injuries at 22 pediatric trauma centers between 2010 and 2015. ERCP details and outcomes were collected. Analysis was performed using descriptive statistics and Wilcoxon rank-sum tests...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29148930/use-of-mixed-oil-fat-emulsion-to-improve-intestinal-failure-associated-liver-disease-in-long-term-home-parenteral-nutrition-a-case-report
#2
Ryan T Hurt, Manpreet S Mundi
Home parenteral nutrition (HPN) is a life-saving therapy for patients who are not able to use their gastrointestinal tract. There are a number of complications associated with HPN, including metabolic bone disease, intestinal failure-associated liver disease (IFALD), and catheter-related bloodstream infections. We present a case of a 32-year-old HPN patient who initially developed biopsy-proven IFALD (total bilirubin, 2.4 mg/dL) while on long-term HPN. His HPN was initiated due to myopathic intestinal dysmotility and pseudo-obstruction when he was 15 years old...
November 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29106286/duodenal-lengthening-in-an-adult-with-ultra-short-bowel-syndrome-a-case-report
#3
Javier Bueno, Rosa Burgos, Susana Redecillas, Manuel López, Joaquin Balsells
BACKGROUND: We have recently demonstrated the feasibility of lengthening the duodenum in children with short bowel syndrome and a dilated duodenum. This procedure gains additional intestinal length in a challenging area of autologous gut reconstruction. Herein, we report the successful application of this technique in an adult with ultra-short bowel syndrome. METHODS: A 25-year-old man with a history of mid-gut volvulus was referred to our center for intestinal transplant evaluation...
November 6, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29100225/acute-pancreatitis-etiology-pathology-diagnosis-and-treatment
#4
Shirin Majidi, Adam Golembioski, Stephen L Wilson, Errington C Thompson
Acute pancreatitis is a fascinating disease. In the United States, the two most common etiologies of acute pancreatitis are gallstones and excessive alcohol consumption. The diagnosis of acute pancreatitis is made with a combination of history, physical examination, computed tomography scan, and laboratory evaluation. Differentiating patients who will have a benign course of their pancreatitis from patients who will have severe pancreatitis is challenging to the clinician. C-reactive protein, pro-calcitonin, and the Bedside Index for Severity of Acute Pancreatitis appeared to be the best tools for the early and accurate diagnosis of severe pancreatitis...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29056001/-research-advances-in-liver-diseases-associated-with-parenteral-nutrition
#5
H N Ren, W X Huang
For patients with gastrointestinal dysfunction or failure, although parenteral nutrition can maintain nutrition and save their lives, lack of food stimulus during the fasting period can cause abnormal secretion of gastrointestinal fluid, bile, and pancreatic juice, which may result in the abnormal secretion of a series of enzymes and lead to the development of various liver diseases. Recent research has focused on the prevention and treatment of such diseases, and this article reviews the research advances in recent years...
July 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29049233/pediatric-types-i-and-vi-choledochal-cysts-complicated-with-acute-pancreatitis-and-spontaneous-perforation-a-case-report-and-literature-review
#6
Ching-Chung Tsai, Po-Kai Huang, Hsien-Kuan Liu, Yu-Tsun Su, Ming-Chun Yang, Ming-Lun Yeh
RATIONALE: Choledochal cysts are a congenital disorder of the common bile duct that can cause progressive biliary obstruction and biliary cirrhosis. They were classified by Todani into five types. Of these, type VI choledochal cysts are rarely reported in the literature. PATIENT CONCERNS: A 22-month-old girl presented with intermittent epigastralgia for approximately 10 days and fever for three days. Fasting and total parenteral nutrition were administered after admission...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28985843/total-parenteral-nutrition-in-patients-following-pancreaticoduodenectomy-lessons-from-1184-patients
#7
Cullen E Worsh, Talar Tatarian, Awinder Singh, Michael J Pucci, Jordan M Winter, Charles J Yeo, Harish Lavu
BACKGROUND: Total parenteral nutrition (TPN) has historically been used conservatively in the management of patients after pancreaticoduodenectomy (PD). Herein, we evaluate the indications for and outcomes associated with TPN use in a high-volume pancreatic surgery center. MATERIALS AND METHODS: We retrospectively queried our institution's pancreatic surgery database for patients who received TPN after PD from 2006 through 2015. RESULTS: Of 1184 patients who underwent PD, 232 (19...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28930953/proposed-clinical-pathway-for-nonoperative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#8
MULTICENTER STUDY
Bindi J Naik-Mathuria, Eric H Rosenfeld, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Adam Vogel, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Sandler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for nonoperative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (American Association of Surgeons for Trauma grade III-V) pancreatic injuries treated with NOM between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28912191/high-versus-low-energy-administration-in-the-early-phase-of-acute-pancreatitis-goulash-trial-protocol-of-a-multicentre-randomised-double-blind-clinical-trial
#9
Katalin Márta, Anikó N Szabó, Dániel Pécsi, Péter Varjú, Judit Bajor, Szilárd Gódi, Patrícia Sarlós, Alexandra Mikó, Kata Szemes, Mária Papp, Tamás Tornai, Áron Vincze, Zsolt Márton, Patrícia A Vincze, Erzsébet Lankó, Andrea Szentesi, Tímea Molnár, Roland Hágendorn, Nándor Faluhelyi, István Battyáni, Dezső Kelemen, Róbert Papp, Attila Miseta, Zsófia Verzár, Markus M Lerch, John P Neoptolemos, Miklós Sahin-Tóth, Ole H Petersen, Péter Hegyi
INTRODUCTION: Acute pancreatitis (AP) is an inflammatory disease with no specific treatment. Mitochondrial injury followed by ATP depletion in both acinar and ductal cells is a recently discovered early event in its pathogenesis. Importantly, preclinical research has shown that intracellular ATP delivery restores the physiological function of the cells and protects from cell injury, suggesting that restoration of energy levels in the pancreas is therapeutically beneficial. Despite several high quality experimental observations in this area, no randomised trials have been conducted to date to address the requirements for energy intake in the early phase of AP...
September 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28902787/venous-thromboembolism-is-associated-with-adverse-outcomes-in-hospitalized-patients-with-acute-pancreatitis-a-population-based-cohort-study
#10
Guru Trikudanathan, Chandraprakash Umapathy, Satish Munigala, Mahesh Gajendran, Darwin L Conwell, Martin L Freeman, Somashekar G Krishna
OBJECTIVES: The systemic inflammatory cascade and vascular stasis in hospitalized patients with acute pancreatitis (AP) serve as a milieu for development of venous thromboembolism (VTE). Our aim was to estimate the prevalence and risk factors of VTE in AP and to evaluate its impact on clinical outcomes of AP. METHODS: The Nationwide Inpatient Sample (2002-2011) was reviewed to identify all patients hospitalized with AP. Patients with a concomitant diagnosis of VTE were compared with those without...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28901335/enteral-versus-parenteral-nutrition-in-critically-ill-patients-with-severe-pancreatitis-a-meta-analysis
#11
REVIEW
H Yao, C He, L Deng, G Liao
Whether enteral nutrition (EN) is superior to parenteral nutrition (PN) in critically ill patients with severe acute pancreatitis remains unknown. The objective of this meta-analysis was to assess the effects of EN versus PN on clinical outcomes in a subgroup of pancreatitis patients. Relevant randomized controlled trials (RCTs) were searched in Scopus, PubMed and Web of Science from inception to August 2016. Ultimately, five RCTs including 348 patients were enrolled in this analysis. Compared with PN, EN was associated with a significant reduction in overall mortality (risk ratio (RR)=0...
September 13, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28886723/pancreatic-injury-in-children-a-case-report-and-review-of-the-literature
#12
Fayza Haider, Mohammed Amin Al Awadhi, Eizat Abrar, Mooza Al Dossari, Hasan Isa, Husain Nasser, Hakima Al Hashimi, Sharif Al Arayedh
BACKGROUND: Trauma is the main cause of morbidity and mortality in the pediatric population. Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury, although uncommon (2 to 9%), is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. Computed tomography currently is the imaging modality of choice. As the incidence of pancreatic injury in children sustaining blunt abdominal trauma is low, management remains a challenge...
September 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28870723/managing-malnourishment-in-pregnancy-after-bariatric-surgery
#13
Rachel K Harrison, Charles Berkelhammer, Victor Suarez, Helen H Kay
BACKGROUND: Little information exists to guide monitoring and treatment of malnourishment during pregnancy after bariatric surgery. Here we present a case with severe deficiencies and recommendations for testing and treatment. CASE: Our patient underwent a duodenal switch procedure resulting in significant weight loss and numerous deficiencies. She then experienced a neonatal demise with multiple congenital abnormalities, including diaphragmatic hernia, possibly related to severe vitamin A deficiency...
September 1, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28727475/guidance-for-supplemental-enteral-nutrition-across-patient-populations
#14
Douglas L Nguyen
Enteral nutrition is preferred over parenteral nutrition as a result of the greater safety of enteral nutrition therapy and comparative convenience. A wide variety of enteral nutrition products have been developed, including disease-specific products to help manage the nutritional needs of patients with kidney failure, liver failure, lung disease, diabetes, and other conditions. An assessment of each patient's nutritional needs and digestive function should be conducted prior to initiation of enteral nutrition therapy...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28713382/recent-advances-on-nutrition-in-treatment-of-acute-pancreatitis
#15
REVIEW
Li-Long Pan, Jiahong Li, Muhammad Shamoon, Madhav Bhatia, Jia Sun
Acute pancreatitis (AP) is a common abdominal acute inflammatory disorder and the leading cause of hospital admission for gastrointestinal disorders in many countries. Clinical manifestations of AP vary from self-limiting local inflammation to devastating systemic pathological conditions causing significant morbidity and mortality. To date, despite extensive efforts in translating promising experimental therapeutic targets in clinical trials, disease-specific effective remedy remains obscure, and supportive care has still been the primary treatment for this disease...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28678307/effect-of-early-enteral-nutrition-en-on-endotoxin-in-serum-and-intestinal-permeability-in-patients-with-severe-acute-pancreatitis
#16
Q-X Shen, G-X Xu, M-H Shen
OBJECTIVE: This work aimed at studying the effect of early enteral nutrition (EN) on serum endotoxin and intestinal permeability in patients with severe acute pancreatitis. PATIENTS AND METHODS: 70 cases of patients with severe acute pancreatitis were cured in our hospital from April 2015 to January 2016. Patients selected were randomly divided into two groups including a group of patients having parenteral nutrition (group PN) and that had enteral nutrition (group EN)...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28676052/comparison-of-different-feeding-regimes-after-pancreatoduodenectomy-a-retrospective-cohort-analysis
#17
Théophile Guilbaud, David Jérémie Birnbaum, Sandrine Loubière, Julien Bonnet, Sophie Chopinet, Emilie Grégoire, Stéphane Berdah, Jean Hardwigsen, Vincent Moutardier
BACKGROUND: Delayed gastric emptying (DGE) is the most frequent pancreatic specific complication (PSC) after pancreaticoduodenectomy (PD). Several gastric decompression systems exist to manage DGE. Patients with a pancreatic tumor require prolonged nutrition; however, controversies exist concerning nutrition protocol after PD. The aim of the study was to assess the safety and efficacy of nasogastric (NG), gastrostomy (GT), and gastrojejunostomy (GJ) tubes with different feeding systems on postoperative courses...
July 4, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28645741/chylous-ascites-due-to-idiopathic-chronic-pancreatitis-managed-with-endoscopic-stenting
#18
Amit Kumar, Harshal S Mandavdhare, Surinder S Rana, Rajesh Gupta, Vishal Sharma
Chylous ascites is an uncommon clinical entity, which usually results from congenital or acquired abnormality in proper lymphatic flow. While the common causes are related to trauma, malignancy or tuberculosis, pancreatic disorders can occasionally result in chylous ascites. Sporadic cases of chylous ascites due to acute or chronic pancreatitis or surgery for pancreatitis have been reported. The usual management is with medium chain triglycerides (MCT), total parenteral nutrition and octreotide. We report a case of a young male with idiopathic chronic pancreatitis who presented with chylous ascites which did not respond to MCT based diet and octreotide...
June 20, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28625150/update-on-the-molecular-mechanisms-underlying-the-effect-of-cholecystokinin-and-cholecystokinin-1-receptor-on-the-formation-of-cholesterol-gallstones
#19
Helen H Wang, Piero Portincasa, David Q-H Wang
Cholecystokinin (CCK) is an important neuro-intestinal peptide hormone produced by the enteroendocrine I-cells in the upper part of small intestine. Protein- and fat-enriched food plays an important role in triggering CCK secretion from the intestine. Carbohydrates stimulate only small amounts of CCK release. The CCK-1 receptor (CCK-1R) is largely localized in the gallbladder, sphincter of Oddi, pancreas, small intestine, gastric mucosa, and pyloric sphincter, where it is responsible for CCK to regulate multiple digestive processes including gallbladder contraction, pancreatic secretion, small intestinal transit, and gastric emptying...
June 19, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28590353/proposed-clinical-pathway-for-non-operative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#20
Bindi J Naik-Mathuria, Eric H Rosenfeld, Adam Vogel, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Alex Ler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for non-operative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers in order to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (AAST grade III-V) pancreatic injuries treated with NOM between 2010-15...
June 6, 2017: Journal of Trauma and Acute Care Surgery
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