Background/aim: Enteral feeding and immunonutrition (ImN) have been shown to be associated with a number of favorable effects in patients undergoing cancer surgery. In this prospective study, we aimed to assess the perioperative use of enteral immunonutrition in patients undergoing radical gastrointestinal surgery for malignancy.Materials and methods: Forty-one patients with malignancy were included in this study and were randomized into one of the two following nutritional strategies: enteral only (EN) or enteral with enteral immunonutrition (ENIN). These regimens were followed for 7 days perioperatively by all patients. Nutritional parameters and postoperative morbidity, mortality, and length of hospital stay (LHS) were assessed.Results: Serum prealbumin levels increased significantly in the ENIN group (P = 0.033). Moreover, patients in the ENIN group showed a more marked decrease in the rate of postoperative infections (P = 0.021) and anastomotic leakage (P = 0.018) than patients fed with EN. In the EN group, LHS was significantly longer than that in the ENIN group (18 vs. 12 days) (P = 0.032). Rates of overall morbidity and mortality were similar in the two groups (P > 0.05).
Conclusion:ENIN was found to have a favorable effect on the outcome of radical gastrointestinal surgery for malignancy. Meticulous preoperative assessment of malnutrition and at least a 7-day perioperative enteral use can increase the effectiveness of immunonutrition.
Although foreign body ingestion is a common problem in children, it is also seen among adults. Perforation of the gut by a foreign body, followed by migration of the foreign body to the liver is quite rare. Most fish bone ingestions have uneventful outcome. However, occasionally, it can cause serious complications if the gastrointestinal tract is perforated. Herein, a case of liver abscess caused by a fish bone is reported. To the best of our knowledge, it is the first case in our country.
A AB BS S T TR RA AC CT T Appendicitis is the most common condition causing acute abdomen. The relationship of parasitic infestation with acute appendicitis has been a controversial issue. A 41-years-old female patient presented with abdominal pain in the right lower quadrant for 48 hours, followed by nausea and vomiting. She underwent laparotomy with a McBurney's incision. We could identify appendicitis with the presence of an Ascaris lumbricoides worm occupying the appendiceal lumen and extending to the cecum and ileocecal valve. In our opinion Ascaris lumbricoides with acute appendicitis is rare clinical case; especially for nonendemic areas. Even if it is a rare condition, it should be kept in mind. 1 Parasitic infestation which is related with acute appendicitis has been a controversial issue in terms of it's role in the etiology of acute appendicitis.2 Ascaris worms could be found in people of all ages . However particulary children are the most probably to be heavily infected. Moreover adult Ascaris lumbricoides is a rare cause of appendicitis. In this study we present the case of acute appendicitis resulting from adult form of Ascaris lumbricoides in adult patient.
CASE REPORTA 41-years-old female patient presented with abdominal pain in the right lower quadrant for 48 hours, followed by nausea and vomiting. She had Turkiye Klinikleri J Case Rep 2016;24 (1) 39
The available findings suggest that intra-abdominal pressure greater than 15 mmHg could irreversibly damage pulmonary cells and both coagulation necrosis parameters and the number of apoptosis increase in accordance with the pressure level.
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