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• W2922085384 abstract "Purpose: Recent guidelines for acute pancreatitis (AP) preferentially recommend the initiation of enteral nutritional support in severe AP in patients who are unable to consume oral nourishment for several weeks, based on assessment in the first 3-4 days of illness. There is limited data on the use of enteral nutrition in mild AP as patients are usually able to resume oral diet within 3-7 days. Enteral nutrition is important in AP for gut mucosal barrier maintenance and prevention of local and systemic infectious complications. We studied all patients with AP at our institution who received post-pyloric enteral nutrition (PPEN) to identify any cases of mild AP receiving the same and the reasons for such nutritional support. Methods: Patients admitted to the Mayo Clinic Rochester hospitals from 2005-2008 with the diagnosis of AP who had post-pyloric feeding tubes placed by either GI endoscopic route or interventional radiology route were retrospectively identified from the hospital databases. Based on a comprehensive chart review, they were categorized as having mild AP first by the Atlanta classification and then by the more recent criteria of the lack of persistent organ failure (> 48 hours) or local complications and APACHE II score < 8. In each case, the reason for PPEN was identified based on a review of clinical notes. Results: From 2005-2008, 49 patients with AP admitted at our institution received PPEN. Of these, 3 had mild AP by Atlanta classification. When the more recent criteria is used, all 3 patients, with the addition of 2, were identified as having mild AP (M:F;1:4), for a total of 5 patients. Four of them were initiated on PPEN ranging from day 2 to day 21 of illness, due to exacerbation of abdominal pain with oral diet. The remaining patient was initiated on PPEN on day 6 of illness for reasons not documented. Duration of PPEN ranged from 3 to 127 days. Mean duration from initiation of PPEN to hospital discharge was 9.4 days. Two were discharged home on PPEN, and continued to require prolonged PPEN (36 and 127 days respectively) before successful advancement of oral diet. All but one patient tolerated PPEN without complications. This patient had tube blockage on day 30 of PPEN, requiring a tube replacement. Conclusion: Five of the 49 patients with AP who received PPEN at our institution (10%) had mild AP. Although most patients with mild AP tolerate oral diet restoration, some are unable to maintain this due to exacerbation of abdominal pain, and are initiated on PPEN. Prospective studies on the role of PPEN in mild AP, and the timing for consideration of PPEN in such patients should be considered. Efforts should also be made to identify the risk factors that predict such patients." @default.
• W2922085384 created "2019-03-22" @default.
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• W2922085384 date "2010-10-01" @default.
• W2922085384 modified "2023-09-27" @default.
• W2922085384 title "Is Post-pyloric Enteral Feeding Administered in Mild Acute Pancreatitis?: Four Year Experience at a Tertiary Institution" @default.
• W2922085384 doi "https://doi.org/10.14309/00000434-201010001-00147" @default.
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