[Zinc deficiency caused by postgastrectomy fistula with high flow in a patient undergoing prolonged parenteral nutrition].
A case is presented of a 57-year-old male patient who underwent total gastrectomy due to gastric adenocarcinoma. During the postoperative period the patient required long-term parenteral nutrition due to a high-debit GI fistula (over 700 ml/day) and sepsis. Two months after parenteral nutrition was started, the patients presented irritability, mucocutaneous lesions and progressive bolding. Serum alkaline phosphatase and zinc levels were lower than normal, although a supplemental 0.03 mg/k/day of zinc was administered. Faced with this zinc deficiency picture, 10 mg zinc sulfate was administered parenterally on a daily basis. The deficiency picture improved markedly over a week's period, and serum zinc and alkaline phosphatase levels returned to normal. The importance of zinc balance control in patients under long-term parenteral nutrition and high fluid debit through GI fistulas is highlighted.
Ortiz
J
J
Cirugía General B, Hospital Civil de Basurto, Bilbao.
Ariño
J
J
Serna
A
A
Santos
I
I
Apecechea
A
A
Iturburu
I
I
García Peña
J M
JM
D003108:Colonic Diseases / Q000150:complications*; D005402:Fistula / Q000150:complications*; D005743:Gastrectomy; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications; D012871:Skin Diseases / Q000150:complications*; D013997:Time Factors; D015032:Zinc / Q000172:deficiency*
D015032:Zinc
Déficit de zinc debido a fístula posgastrectomía de alto débito en paciente sometido a nutrición parenteral prolongada.