One Case of Esophageal Obstruction Caused by Enteral Nutrition

Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v2i2.350

Yangzhong Wang, Xiuqing Liao, Nan Tang, Xianlin Peng, Xiaoli Bao

Department of respiratory and critical care medicine, Fuling Central Hospital, Chongqing 408000, China

Abstract

We report a case of complete esophageal obstruction caused by continuous enteral nutrition infusion via nasogastric tube. A 77 year old man received mechanical ventilation due to severe pneumonia and severe respiratory distress. He began using enteral nutrition emulsion (TPF) through a nasogastric tube on admission. 15 days later, due to the difficulty of re-inserting the nasogastric tube, endoscopy found a large number of coagulations in the esophagus, resulting in complete esophageal obstruction. We remove a small part of the foreign body with a net basket under gastroscope. After the operation, the nasogastric tube was placed in the middle of the esophagus again, which was perfused with 5% sodium bicarbonate and vinegar through the gastric tube. One week later, the esophagus was completely unobstructed by gastroscopy. A conclusion can be drawn that the precipitation and coagulation of TPF can lead to the whole esophageal obstruction. Endoscopic removal of foreign bodies, sodium bicarbonate and vinegar retention in the esophagus can treat the food obstruction caused by TPF.

Keywords

TPF, gastroduodenoscopy, enteral nutrition, esophageal obstruction, sodium bicarbonate, vinegar

Full Text

PDF - Viewed/Downloaded: 24 Times

Indexation

Download Index Record

References

[1] LI Q, ZHANG Z H, XIE B, et al.Effectiveness of enteral feeding protocol on clinical outcomes in critically ill patients:A before and after study. PloS one. 2017; 12(8): e0182393.
[2] Gostyńska A, Stawny M, Dettlaff K, Jelińska A. Clinical Nutrition of Critically Ill Patients in the Context of the Latest ESPEN Guidelines. Medicina (Kaunas). 2019; 55(12): 770. doi: 10.3390/medicina55120770. PMID: 31810303; PMCID: PMC6955661.
[3] ASSIMAKOPOULOS S F, TRIANTOS C, THOMOPOULOS K, et al. Gut-origin sepsis in the critically ill patient:pathophysiology and treatment. Infection. 2018; 46(6): 751-760.
[4] Yan XE, Zhou LY, Lin SR, et al. Therapeutic effect of esophageal foreign body extraction management: flexible versus rigid endoscopy in 216 adults of Beijing. Med Sci Monit. 2014; (20): 2054-2060.
[5] Joundi RA, Saposnik G, Martino R, Fang J, Porter J, Kapral MK. Outcomes among patients with direct enteral vs nasogastric tube placement after acute stroke. Neurology. 2018; 90(7): e544-e552. doi: 10.1212/WNL.0000000000004962. Epub 2018 Jan 24. PMID: 29367443; PMCID: PMC5818013.
[6] Wesselink E, Koekkoek KWAC, Looijen M, van Blokland DA, Witkamp RF, van Zanten ARH. Associations of hyperosmolar medications administered via nasogastric or nasoduodenal tubes and feeding adequacy, food intolerance and gastrointestinal complications amongst critically ill patients: A retrospective study. Clin Nutr ESPEN. 2018; 25: 78-86. doi: 10.1016/j.clnesp.2018.04.001. Epub 2018 Apr 17. PMID: 29779822.
[7] C.S. Ranadheera, et al. Impact of shear and pH on properties of casein micelles in milk protein concentrate. LWT. 2019; 108: 370-376.
[8] Bozena Malmgren, et al. Changes in proteins, physical stability and structure in directly heated UHT milk during storage at different temperatures. International Dairy Journal. 2017; 71: 60-75.
[9] Bonfatti V, de Freitas DR, Lugo A, Vicario D, Carnier P. Effects of the detailed protein composition of milk on curd yield and composition measured by model micro-cheese curd making of individual milk samples. J Dairy Sci. 2019; 102(9): 7863-7873. doi: 10.3168/jds.2018-15743. Epub 2019 Jul 17. PMID: 31326163.
[10] Wang Z, Ding W, Fang Q, Zhang L, Liu X, Tang Z. Effects of not monitoring gastric residual volume in intensive care patients: A meta-analysis. Int J Nurs Stud. 2019; 91: 86-93. doi: 10.1016/j.ijnurstu.2018.11.005. Epub 2019 Jan 3. PMID: 30677592.
[11] Yan XE, Zhou LY, Lin SR, et al.Therapeutic effect of esophageal foreign body extraction management:flexible versus rigid endoscopy in 216 adults of Beijing. Med Sci Monit. 2014(20): 2054-2060.
[12] Marcus EL, Arnon R, Sheynkman A, Caine YG, Lysy J. Esophageal obstruction due to enteral feed bezoar: A case report and literature review. World J Gastrointest Endosc. 2010; 2: 352-356.

Citing this article:

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License