Refeeding syndrome in a woman with pancreatitis: a case report

Abstract

Refeeding syndrome can occur in malnourished patients with acute pancreatitis who have electrolyte imbalances. Refeeding syndrome is characterized by severe electrolyte imbalances (mainly hypophosphatemia, hypomagnesemia, and hypokalemia), vitamin deficiency (mainly thiamine deficiency), fluid overload, and salt retention resulting in organ dysfunction and cardiac arrhythmias. We herein report a case involving a patient with severe pancreatitis and gallbladder stones who developed refeeding syndrome with shock and loss of consciousness. The patient was treated by opportune vitamin and electrolyte supplementation therapy and showed substantial improvement after 2 weeks of hospitalization, gaining the ability to eat small bites of solid food orally. Early diagnosis and treatment of refeeding syndrome may reduce morbidity and mortality in patients with acute pancreatitis. Patients should be fasted only if alimentation is contraindicated, and electrolyte values must be closely monitored.

Risk factors, diagnostic criteria, and incidence of refeeding syndrome in the hospital setting: is there an elephant in the room?

“…Some reports showed that the diagnosis in clinical practice is based in P-levels not in the pre-feeding period but after clinical manifestations of RS occurred. Table 3 summarizes some case reports of hospitalized patients who presented with RF [24][25][26][27][28] . The HP was the criteria used to identify the RS, and the clinical manifestations were the alert to identify the RS through the electrolyte serum levels.…”