Healing One Acute Pancreatitis Patient with the Duodenal Perforation Caused by a Nutritional Tube Misplacement

Wei-Li Yu, Yun Sun, Xiang Yang, Zhonghua Lu
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Abstract

Enteral nutrition support of Acute Pancreatitis (AP) patients via a Nasojejunal Feeding Tube (NJT) is a conventional and rational treatment. The nutritional tube placement accurately is of vital important. Generally, complications of NJT placement are uncommon. A 47-year-old female AP patient was admitted to our ICU. An abdominal X-ray showed that an NJT was in the duodenum drop. And there was an abnormal air pattern in the end of the NJT. A CT scan revealed the retroperitoneal air in the end of the NJT as well as the injection of pan shadow meglumine contrast through gastric tube leakage into jejunum, suggesting a duodenal perforation. Therefore, we placed a new jejunum nutrition tube under gastroscope. One month later CT scan showed that there was no leakage into the original considered duodenal perforation through oral contrast agent. One week later the je - junum nutrition tube was pulled out.
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治疗一例营养管错位致十二指肠穿孔的急性胰腺炎患者
经鼻空肠饲管(NJT)肠内营养支持是急性胰腺炎(AP)患者的一种常规、合理的治疗方法。营养管的准确放置至关重要。通常,NJT放置的并发症并不常见。一名47岁女性AP患者入住我们的ICU。腹部x线片显示NJT位于十二指肠。在NJT结束时出现了异常的空气模式。CT扫描显示NJT末端有腹膜后气体,经胃管漏入空肠注射有影显影造影剂,提示十二指肠穿孔。因此,我们在胃镜下放置了一个新的空肠营养管。1个月后CT显示经口服造影剂检查,原认为十二指肠穿孔处未见渗漏。一周后,取出了肠营养管。
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