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Management With Total Parenteral Nutrition and a Venting Enterostomy

Henry A. Pitt, MD; Linda L. Mann, RN; William E. Berquist, MD; Marvin E. Ament, MD; Eric W. Fonkalsrud, MD; Lawrence DenBesten, MD

Arch Surg. 1985;120(5):614-618.

Abstract
• A variety of remedies have been suggested for patients with chronic intestinal pseudo-obstruction. However, none of these treatments have been particularly effective, and many of these patients have died of malnutrition. Therefore, in an effort to maintain nutrition and avoid repetitive nasogastric intubation, 22 patients (12 adults and ten children) with chronic intestinal pseudo-obstruction were managed with long-term total parenteral nutrition (TPN), and 20 also received a "venting" enterostomy. Only two patients had to undergo revision of their gastrostomies. Prior to referral, these 22 patients required 56 admissions for obstruction (1.2 admissions per patient-year). Since the initiation of TPN and placement of a venting enterostomy, these 22 patients required only 17 hospitalizations for obstruction in a total of 80 patient years (0.2 admissions per patient-year). We conclude that patients with chronic Intestinal pseudo-obstruction who receive TPN at home and have a venting enterostomy can be safely managed for prolonged periods and require fewer hospitalizations for obstruction.

Arch Surg 1985;120:614-618)

Author Affiliations
From the Departments of Surgery (Drs Pitt, Fonkalsrud, and DenBesten, and Ms Mann) and Pediatrics (Drs Berquist and Ament), UCLA School of Medicine.

Footnotes
Accepted for publication Feb 6, 1985.

Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 13, 1984.

Reprint requests to 77-130 Center for Health Sciences, UCLA School of Medicine, Los Angeles, CA 90024 (Dr Pitt).

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