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Nutritive Support in the Control of Nutritive Status in Acute Corrosive Poisonings: A Case Report

Author(s): Andon Chibishev

Journal: Macedonian Journal of Medical Sciences
ISSN 1857-5749

Volume: 3;
Issue: 4;
Start page: 395;
Date: 2010;
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Keywords: Corrosive poisonings | esophageal burns | esophagogastroduodenoscopy | enteral nutrition | parenteral nutrition.

Acute poisonings with corrosive substances are one of the most difficult poisonings in the clinical toxicology. Here we present a case of a woman who survived poisoning with hydrochloric acid, and in the course of five months she was given artificial enteral nutrition through a feeding gastro-jejunostoma. In the first 24 hours after hospitalization, an emergency esophagogastroduodenoscopy was done and corrosive damages were observed along the esophagus, in the stomach and partially in the duodenum that bled temporarily. Postcorrosive burns of the esophagus and stomach of grade III according to Kikendal’ classification were confirmed and bleeding from the mucous membrane, submucosis and muscle layer.The intensive worsening of the general condition because of the stress and acute hunger, indicated that feeding gastro-jejunostoma should be inserted after the fifth day of hospitalization when an abdominal surgeon was consulted. During her stay in the hospital, nutritive status of the patient was monitored (body weight, body mass index, total proteins, albumins, nitrogen loss, nitrogen balance). The intensive hyper-alimentation improved the general condition and it stabilized the laboratory, metabolic and immunology parameters. After six months of home enteral nutrition, a partial resection of the distal part of esophagus and total gastrectomy were indicated because the patient had definite post-corrosive sequels.
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