Journal
JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
Volume 28, Issue 1, Pages 27-29Publisher
AMER SOC PARENTERAL & ENTERAL NUTRITION
DOI: 10.1177/014860710402800127
Keywords
-
Categories
Funding
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL064195] Funding Source: NIH RePORTER
- NHLBI NIH HHS [HL 64195] Funding Source: Medline
Ask authors/readers for more resources
Background: Fifteen reports of bowel necrosis in patients receiving jejunal feeding have been reported. Etiology remains unexplained. Methods: A patient with a 60% burn receiving jejunostomy tube feeding developed hypernatremia and was given distilled water in the jejunum, 400 mL every 2 hours. One week later, he developed an acute abdomen with abdominal distention. At operation, he had 4 L of cloudy fluid containing jejunal feeding. Three large duodenal perforations were present. The jejunostomy site was normal. In an animal study, water or normal saline (0.85% NaCl) were infused into the mid small bowel, and sections of bowel were taken 5 minutes later for histologic study. Results: Animal study of the effect of water in the rat intestine revealed disruption of intestinal epithelium. It is suggested that disruption of epithelium by electrolyte-free water may permit digestion of the bowel wall and result in perforation, as was observed in this patient. This mechanism may have been responsible for some of the cases reported in the literature. Conclusions: Tap or distilled water may injure intestinal epithelium and should not be infused directly into the small bowel as jejunal feeding.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available