Acute abdominal pain due to early postoperative elemental feeding by needle jejunostomy.
Early postlaparotomy needle jejunostomy feeding with an elemental diet resulted in a typical clinical entity in six of 160 patients (4 per cent). In all, an acute condition of the abdomen developed with a grossly distended intestine, filled with fluid and gas, and an empty stomach as confirmed roentgenographically or at a second laparotomy. This complication is presumably caused by carbohydrate hyperosmolarity of the elemental diet and carbon dioxide production by fermentation. The complication was seen predominantly in patients with a Roux-en-Y reconstructed pancreatectomy. In two patients, a negative second laparotomy was performed. In two others, a pancreaticojejunostomy suture line blowout followed, resulting in death. One patient died after aspiration of the gastric contents.
D000005:Abdomen; D000208:Acute Disease; D000368:Aged; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007583:Jejunum; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010180:Pancreatectomy / Q000379:methods; D011184:Postoperative Period; D013997:Time Factors