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Nutritional management in an elderly man with esophageal and gastric necrosis after caustic soda ingestion: a case report

Authors Rondanelli M, Peroni G, Miccono A, Guerriero F, Guido D, Perna S

Received 23 July 2015

Accepted for publication 30 September 2015

Published 4 February 2016 Volume 2016:12 Pages 129—133


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Garry Walsh

Video abstract presented by Dr Simone Perna.

Views: 292

Mariangela Rondanelli,1 Gabriella Peroni,1 Alessandra Miccono,2 Fabio Guerriero,3 Davide Guido,3,4 Simone Perna1

1Department of Public Health, Neuroscience, Experimental and Forensic Medicine, Endocrinology and Nutrition Unit, University of Pavia, Azienda di Servizi alla Persona di Pavia, Pavia, 2Department of Clinical Sciences, Faculty of Medicine and Surgery, University of Milano-Bicocca, Milan, 3Azienda di Servizi alla Persona di Pavia, 4Department of Public Health, Neuroscience, Experimental and Forensic Medicine, Biostatistics and Clinical Epidemiology Unit, University of Pavia, Pavia, Italy

Abstract: The ingestion of corrosive industrial chemical agents, such as caustic soda, that are mostly used for household cleaning, usually occurs accidentally or for suicidal purposes. Multiple protocols are based on documented success in preventing impending complications. In this study, we present a case of a 70-year-old man who swallowed caustic soda in a suicide attempt, causing a development of strong esophageal and gastric necrosis with subsequent gastrectomy and digiunostomy. Initially, the recommended nutritional approach was via percutaneous endoscopic jejunostomy by a polymer and high-caloric formula, with an elevated content of soluble fiber. After 5 months, the medical team removed the percutaneous endoscopic jejunostomy and the patient switched from enteral to oral nutrition. In this step, it was decided to introduce two oral, high-caloric supplements: an energy supplement in powder, based on maltodextrin, immediately soluble in foods or in hot/cold drinks and a high-energy and protein drink, enriched with arginine, vitamin C, zinc, and antioxidants. Oral administration (per os) was well tolerated by consuming homogenized food mixed in water. After 1 month, the patient was discharged from the hospital and was able to eat a regular meal.

Keywords: nutritional management, enteral nutrition, gastric necrosis, esophageal necrosis, nutritional supplementation, elderly, caustic soda ingestion

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