Early selective enteral feeding in treatment of acute pancreatitis: A case report

• Published in: World journal of clinical cases Vol. 12; no. 3; pp. 637 - 642
• Main Authors: Kashintsev, Aleksei A, Anisimov, Sergey V, Nadeeva, Anastasya, Proutski, Vitali
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 26.01.2024
• Subjects: Case Report; Infectious complications; Acute pancreatitis; Systemic inflammatory response syndrome; MODS; Enteral feeding
• ISSN: 2307-8960; 2307-8960
• DOI: 10.12998/wjcc.v12.i3.637

Early initiation of enteral feeding is recognized to play a crucial role in improving the outcomes of treatment of acute pancreatitis. However, the method of administration of enteral nutrition remains debatable. We present the experience of treating a patient with moderate-severe acute pancreatitis, at high risk of progressing to a severe or fatal condition, using a novel method of selective feeding with duodenal isolation. A 27-year-old female patient presented to the emergency unit of the hospital with a typical manifestation of acute pancreatitis. Despite a conventional treatment, the patient's condition deteriorated by day 2 of hospitalization. Using an endoscopic approach, a novel catheter PandiCath was placed to the duodenum of the patient, isolating its segment between the duodenal bulb and the ligament of Treitz. In the isolated area created, a negative pressure was applied, followed by introduction of early selective enteral feeding. The patient's condition subsequently improved in a rapid manner, and no complications often associated with moderate-to-severe acute pancreatitis developed. Within 48 h of starting treatment with the novel method, it can prevent the development of multiple organ failure and, when combined with minimally invasive drainage methods, help prevent infection.