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Alberto Patriti, MD; Luigina Graziosi, MD; Annibale Donini, MD

Arch Surg. 2007;142(1):100-101.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with interest the article by Melis at al¹ reporting a case of bowel necrosis during postoperative enteral feeding, a procedure extensively used in upper digestive surgery. The authors reviewed the possible mechanisms underlying this complication, and increased energy demand from the enterocytes is ascribed as one of the factors contributing to the nonocclusive necrosis of the bowel in association with bacterial overgrowth and tube-feeding composition.¹ Nevertheless, the authors conclude that from the available data, it is not possible to identify risk factors for intestinal ischemia during enteral feeding, omitting in their review important variables such as feeding interval and feeding type.¹

It is our opinion that a mismatch of the oxygen demand-supply ratio in the intestinal mucosa plays the major role in this setting. In the presence of luminal nutrients, the splanchnic blood flow increases up to 200% above . . . [Full Text of this Article]

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RELATED LETTER

Bowel Necrosis Associated With Early Jejunal Tube Feeding—Reply
Marcovalerio Melis, Alessandro Fichera, and Mark K. Ferguson
Arch Surg. 2007;142(1):101.
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