Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2024; 12(20): 4384-4390
Published online Jul 16, 2024. doi: 10.12998/wjcc.v12.i20.4384
New application of intestinal obstruction catheter in enterocutaneous fistula: A case report
Xiao-Tong Wang, Long Wang, An-Lin Liu, Jing-Le Huang, Lei Li, Zhi-Xing Lu, Wei Mai
Xiao-Tong Wang, Long Wang, An-Lin Liu, Jing-Le Huang, Lei Li, Zhi-Xing Lu, Wei Mai, Departments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Wang XT and Lu ZX performed the data analyses and wrote the manuscript; Mai W and Li L contributed to the conception of the study; Wang L and Liu AL contributed significantly to the analysis and manuscript preparation; and Huang JL helped perform the analysis with constructive discussions.
Supported by the Guangxi Popularization and Application Program of Appropriate Medical Care and Public Health Technology, No. S2021043 and No. S2022002; and the Science and Technology Research Project of the Health Commission of Guangxi Zhuang Autonomous Region No. Z-A20230002.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Mai, BMed, Chief Doctor, Departments of Gastrointestinal, Hernia and Enterofistula Surgery, People's Hospital of Guangxi Zhuang Autonomous Region & Institute of Minimally Invasive Technology and Applications, No. 6 Taoyuan Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. 13977154858@139.com
Received: March 24, 2024
Revised: May 14, 2024
Accepted: May 23, 2024
Published online: July 16, 2024
Processing time: 97 Days and 15.1 Hours
Abstract
BACKGROUND

Enterocutaneous fistula (ECF) is an abnormal connection between the gastrointestinal tract and the skin. ECF can lead to massive body fluid loss, hypercatabolism, and malnutrition. Therefore, nutritional support plays a crucial role in managing ECFs and promoting the healing of fistulas. For nutritional support, enteral nutrition (EN) is the preferred method when gastrointestinal function is recovering. Currently, various EN approaches have been applied for different anatomical positions of the ECF. However, the effectiveness of administering EN support for treating lower ECFs still needs further exploration and improvement.

CASE SUMMARY

We present the case of a 46-year-old male who underwent gastrointestinal stromal tumour resection. Six days after the surgery, the patient presented with fever, fatigue, severe upper abdominal pain, and septic shock. Subsequently, lower ECFs were diagnosed through laboratory and imaging examinations. In addition to symptomatic treatment for homeostasis, total parenteral nutrition support was administered in the first 72 h due to dysfunction of the intestine. After that, we gradually provided EN support through the intestinal obstruction catheter in consideration of the specific anatomic position of the fistula instead of using the nasal jejunal tube. Ultimately, the patient could receive optimal EN support via the catheter, and no complications were found during the treatment.

CONCLUSION

Nutritional support is a crucial element in ECF management, and intestinal obstruction catheters could be used for early EN administration.

Keywords: Enterocutaneous fistula, Intestinal obstruction catheter, Nutritional support, Enteral nutrition pathway, Case report

Core Tip: Early enteral nutrition support is crucial in the management of enterocutaneous fistulas. The method of enteral nutrition (EN) support could vary for enterocutaneous fistula (ECF) patients with different anatomical fistula locations. This study reported a novel, safe and efficient method of establishing early EN administration for ECF patients with intestinal obstruction catheters in which treatment strategies were tailored for rapid rehabilitation.