Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2024; 12(3): 637-642
Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.637
Early selective enteral feeding in treatment of acute pancreatitis: A case report
Aleksei A Kashintsev, Sergey V Anisimov, Anastasya Nadeeva, Vitali Proutski
Aleksei A Kashintsev, Sergey V Anisimov, Anastasya Nadeeva, Vitali Proutski, PANDICA LTD, London WC1N 3ES, United Kingdom
Author contributions: Kashintsev AA engaged the patient and wrote the manuscript; Anisimov SV and Proutski V wrote the manuscript; Nadeeva AA and Proutski V analyzed the data.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: All the authors declare that there are no conflicting interests 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: Aleksei A Kashintsev, MD, PhD, Research Scientist, Senior Scientist, Surgeon, PANDICA LTD, 22 Great James Street, London WC1N 3ES, United Kingdom. alexey.kashintsev@pandica.com
Received: November 8, 2023
Peer-review started: November 8, 2023
First decision: December 5, 2023
Revised: December 8, 2023
Accepted: January 5, 2024
Article in press: January 5, 2024
Published online: January 26, 2024
Processing time: 69 Days and 3.7 Hours
Abstract
BACKGROUND

Early initiation of enteral feeding is recognized to play a crucial role in improving the outcomes of treatment of acute pancreatitis. However, the method of administration of enteral nutrition remains debatable. We present the experience of treating a patient with moderate-severe acute pancreatitis, at high risk of progressing to a severe or fatal condition, using a novel method of selective feeding with duodenal isolation.

CASE SUMMARY

A 27-year-old female patient presented to the emergency unit of the hospital with a typical manifestation of acute pancreatitis. Despite a conventional treatment, the patient’s condition deteriorated by day 2 of hospitalization. Using an endoscopic approach, a novel catheter PandiCath® was placed to the duodenum of the patient, isolating its segment between the duodenal bulb and the ligament of Treitz. In the isolated area created, a negative pressure was applied, followed by introduction of early selective enteral feeding. The patient’s condition subsequently improved in a rapid manner, and no complications often associated with moderate-to-severe acute pancreatitis developed.

CONCLUSION

Within 48 h of starting treatment with the novel method, it can prevent the development of multiple organ failure and, when combined with minimally invasive drainage methods, help prevent infection.

Keywords: Acute pancreatitis; Enteral feeding; Infectious complications; Systemic inflammatory response syndrome; MODS

Core Tip: Acute pancreatitis represents a common surgical disease; its moderate and severe forms are often associated with development of life-threatening complications. We report a case of acute pancreatitis where a standard treatment was augmented with duodenum decompression using a catheter of special design, further allowing introduction of early selective enteral feeding, leading to rapid improvement of the patient’s condition, with no complications. Our observations suggest that this approach may be beneficial for moderate and severe cases of acute pancreatitis.