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Published Paper Details:
Nutritional management and rehabilitation for SMA thrombosis with high ileostomy output. Multidisciplinary care- case report
Authors
Anusuya.M,Dr. Vinitha,Dr. Sairam,Dr. Kalavathy. S,Dr. Anbalagan
Downlaod Center
Keywords
Keywords: Mesenteric ischemia, short bowel syndrome, parenteral nutrition
Abstract
Background
SMA syndrome is a rare case of upper GI obstruction rapid weight loss can be implicated in this syndrome timely intervention of nutritional support prevents malnutrition and its related problems. SMA is a surgical emergency during treatment most of the patients require nutritional Treatment with multidisciplinary team care. However, achieving the nutritional goal may be not always possible. So our study aimed to investigate the nutritional management of the patient who was operated on for an acute mesenteric artery. It maintains with non-specific syndromes like nausea, vomiting, anorexia, and epigastric pain and it if left untreated can result us significant imbalance and other mortalities associated with malnutrition.
Aim
To improve the survival rate and also to improve the quality of life through a customized medical nutrition therapy plan.
Materials and Methods
For patients who were diagnosed and hospitalized for acute mesenteric ischemia, the Nutritional management of patients was studied in terms of hospital length of stay, mortality rate, and achieving of nutritional goals. A 39-year-old female was admitted with a complaint of abdominal pain for the past 1 week with c/o of vomiting for 3*4 episodes per day for the past 2 days with food particles with a h/o of co-morbidity diabetic for the past 10 years on medication. On admission as evaluated for the present complaint with a CT abdomen which revealed a complaint of splenic superior mesenteric vessel thrombosis
Surgical Management
For which we underwent explanatory laparotomy with ileocecal resection splenectomy ileostomy, suprarenal aortic thrombectomy SMA embolectomy on time admission. The biochemical parameters revealed anemia (HB-7.6) and other parameters were clinically revealed normal.
Dietary Management
POD-1 initiated On TPN@40ml/hr followed by TPN is gradual to 50 ml by POD-5 ileostomy put was moderate which were able to meet around 68% of calorie to 68% of protein respectively. By POD 6 along with TPN entternal nutrition was indicated where she was started with semi elemental feeds@30ml/hr progressively increased by POD11 were able to meet around 70 % of calorie and protein respectively Contiusoly ileostomy output was increased to 900ml.1500ml respectively. By POD 13 to 39 she was on enteral nutrition and IV amino acids were given to meet the protein requirement. Prevent further management of hypoalbumin throughout POD 12 to 39 average of 2.5 liter of ileostomy output. To prevent electrolyte loss through ileostomy IV fluids were also given to maintain the +ve balance and electrolyte conversion was given simultaneously.
Conclusion
The management of nutritional treatment of acute mesenteric ischemia patients is challenging. Achieving the nutritional goals may not be possible in many patients.
IJCRT's Publication Details
Unique Identification Number - IJCRT2503610
Paper ID - 279171
Author type - Indian Author
Page Number(s) - f298-f304
Pubished in - Volume 13 | Issue 3 | March 2025
DOI (Digital Object Identifier) -
No Of Downloads - 80
Author Country - India, 600049, CHENNAI , CHENNAI , 600049, Health Science All
Publisher Name - IJPUBLICATION | www.ijcrt.org | ISSN : 2320-2882
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Anusuya.M,Dr. Vinitha,Dr. Sairam,Dr. Kalavathy. S,Dr. Anbalagan, "Nutritional management and rehabilitation for SMA thrombosis with high ileostomy output. Multidisciplinary care- case report", International Journal of Creative Research Thoughts (IJCRT), ISSN:2320-2882, Volume.13, Issue 3, pp.f298-f304, March 2025, Available at :http://www.ijcrt.org/papers/IJCRT2503610.pdf
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