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Management of malignancy-associated bowel obstruction by cervical esophagostomy and total parenteral nutrition, case series of 2 patients.

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Citation: International Journal of Surgery Case Reports. 53:390-393, 2018 Nov 16.PMID: 30481740Institution: MedStar Washington Hospital Center | Washington Cancer InstituteDepartment: Surgery/General Surgery | Surgery/Thoracic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2018 ISSN:

2210-2612

Name of journal: International journal of surgery case reportsAbstract: BACKGROUND: Patients with gastrointestinal or gynecologic malignancy may show disease progression within the abdomen and pelvis causing bowel obstruction in the absence of clinical evidence of disease outside of the peritoneal space. Bowel obstruction eventually results and has a profound effect on quality of life eventually leading to the demise of these patients.CONCLUSIONS: Long-term management of malignancy-associated bowel obstruction is possible with improvement in quality of life using a combination of TPN and a cervical esophagostomy tube. In these two cases the cervical esophagostomy tube was placed with limited adverse events, and adequate drainage of intestinal secretions long-term.Copyright (c) 2018. Published by Elsevier Ltd.METHODS: In order to improve the quality of life and combat the requirement for a nasogastric tube, a combination of total parenteral nutrition (TPN) to allow adequate caloric intake plus cervical esophagostomy to drain intestinal secretions was utilized as a palliative treatment long-term for patients with malignancy-associated bowel obstruction.RESULTS: In 2 patients with appendiceal malignancy no cancer spread outside of the peritoneal space occurred. Unfortunately, total obstruction of the bowel caused unremitting nausea, vomiting, and pain accompanied by an inability to take adequate nutrition by mouth. In these 2 patients TPN long-term was initiated and a cervical esophagostomy tube placed percutaneously. Relief of malnutrition and the symptoms of nausea and vomiting were well treated using this combined approach. Pain management continued as an ongoing problem.All authors: Ihemelandu C, Khaitan PG, Sugarbaker PHFiscal year: FY2019Digital Object Identifier:

https://dx.doi.org/10.1016/j.ijscr.2018.11.016

Date added to catalog: 2018-12-14

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Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	30481740	Available		30481740

BACKGROUND: Patients with gastrointestinal or gynecologic malignancy may show disease progression within the abdomen and pelvis causing bowel obstruction in the absence of clinical evidence of disease outside of the peritoneal space. Bowel obstruction eventually results and has a profound effect on quality of life eventually leading to the demise of these patients.

CONCLUSIONS: Long-term management of malignancy-associated bowel obstruction is possible with improvement in quality of life using a combination of TPN and a cervical esophagostomy tube. In these two cases the cervical esophagostomy tube was placed with limited adverse events, and adequate drainage of intestinal secretions long-term.

METHODS: In order to improve the quality of life and combat the requirement for a nasogastric tube, a combination of total parenteral nutrition (TPN) to allow adequate caloric intake plus cervical esophagostomy to drain intestinal secretions was utilized as a palliative treatment long-term for patients with malignancy-associated bowel obstruction.

RESULTS: In 2 patients with appendiceal malignancy no cancer spread outside of the peritoneal space occurred. Unfortunately, total obstruction of the bowel caused unremitting nausea, vomiting, and pain accompanied by an inability to take adequate nutrition by mouth. In these 2 patients TPN long-term was initiated and a cervical esophagostomy tube placed percutaneously. Relief of malnutrition and the symptoms of nausea and vomiting were well treated using this combined approach. Pain management continued as an ongoing problem.

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