ABSTRACT
BACKGROUND: There are few studies examining the effect of jejunal feeding on pancreatic exocrine output. The purpose of this study was to compare the effects of jejunal feeding with an elemental formula (EF) and with a polymeric immune-enhancing formula (PIEF) on pancreatic exocrine function. METHODS: Patients undergoing a partial pancreatectomy had a jejunal feeding tube inserted and a pancreatic stent exteriorized, facilitating collection of pancreatic secretions. Postoperatively, patients underwent a secretin-stimulation test to document adequate pancreatic reserve. Patients were then randomized to receive jejunal feeding with EF or with PIEF for a 24-hour period, followed by a washout period of feeding with dextrose, and subsequent jejunal feeding with EF or PIEF. RESULTS: The secretin-stimulation test demonstrated significant pancreatic reserve in all patients. There was a mild increase in pancreatic exocrine secretion with jejunal feeding with EF and PIEF compared with baseline and with dextrose. There was increased bicarbonate secretion with EF compared with PIEF, but there were no other significant differences in pancreatic exocrine function. CONCLUSIONS: In this model of partial pancreatectomy, there was no significant difference in pancreatic exocrine output when use of an EF was compared with use of a PIEF for jejunal feeding. Further clinical studies are needed to determine the potential role of PIEF in pancreatic disease.
Subject(s)
Enteral Nutrition , Food, Formulated , Pancreas/metabolism , Parenteral Nutrition, Total , Bicarbonates/metabolism , Cross-Over Studies , Female , Humans , Immunity , Jejunum , Male , Middle Aged , Pancreatectomy , Pancreatic Juice/metabolism , Single-Blind MethodABSTRACT
The authors review their experience with lipomas of the colon at St. Boniface General Hospital in Winnipeg, Man., during the period 1974 to 1985, and compare their clinicopathologic evaluation with that reported in the literature. Among 15 patients (average age 66.7 years), the majority of whom were women, 17 lipomas were found; all were submucosal. One-third of the lesions were symptomatic. The most frequent symptoms were abdominal pain, rectal bleeding and a change in bowel habit. Only one patient had multiple lesions. The right colon was most frequently affected. Five patients underwent major colonic resection either because the diagnosis was confused with carcinoma or because of intussusception. Only one patient was treated by colotomy and polypectomy. Although most lipomas are small and asymptomatic, tumours larger than 2 cm tend to produce complications or be confused with carcinoma.
