ABSTRACT
We report two cases of oesophageal bezoar in patients given enteral nutrition by nasogastric tubing in an intensive care unit. These two complications occurred during the year following the replacement of our standard enteral feed by a new preparation enriched in proteins. In both patients, the bezoar could be endoscopically removed. The enteral feeding solution is likely to be responsible for the development of this complication because no other factor known to favour this complication such as concomitant administration of sulfacrate or anti-acid agents was given to the patients; and the bezoar developed shortly after the new enteral feeding solution was used, a hypothesis supported by several similar case reports in the medical literature.
Subject(s)
Bezoars/etiology , Enteral Nutrition/adverse effects , Esophageal Diseases/etiology , Intubation, Gastrointestinal/adverse effects , Aged , Aged, 80 and over , Bezoars/therapy , Critical Care , Esophageal Diseases/therapy , Humans , Male , Middle AgedSubject(s)
Colon/blood supply , Colonic Polyps/surgery , Postoperative Hemorrhage/surgery , Aged , Arteries , Endoscopy, Gastrointestinal , Female , Humans , Male , Middle Aged , Surgical InstrumentsABSTRACT
BACKGROUND: The relationship between malnutrition and complications occuring in hospitalized patients is debated. AIM: To assess prospectively the relationship between nutritional status and percutaneous endoscopic gastrostomy (PEG)-related complications and to determine the respective role of malnutrition and confounding variables on clinical outcome. METHODS: Ninety seven patients were followed up for 30 days after PEG insertion and complications were prospectively recorded. Patients were classified as malnourished when they met one of the following criteria: body mass index<20 kg/m(2) and/or weight loss > 5%. Multivariate logistic regression analysis was used to adjust for age, sex, diagnoses, functional status, antibiotic treatment and duration of hospital stay before PEG insertion. RESULTS: Sixty eight (70.1%) patients were malnourished. A significantly higher number of complications was seen in malnourished than in non malnourished patients (54.4% vs 31%; odds-ratio (OR): 2.65 [CI 95%: 1.06-6.66]; P=0.04). One-month mortality did not significantly differ between malnourished and non malnourished patients. Multivariate analysis showed that malnutrition (OR: 3.15 [1.21-8.24]; P=0.02) and > 10-day hospital stay (OR: 2.77 [1.13-6.82]; P=0.03) were significantly associated with early complications. CONCLUSION: These data suggest that malnutrition increases the risk of early complications after PEG insertion, independently of the underlying diseases and functional status of the patients.
