|Realimentacion digestiva ||en pancreatitis aguda. |
|¿Cuándo y cómo?|
|Digestive refeeding in acute |
|Karin Papapietro V, Michel Marin E, Emma Díaz G1, |
|Guillermo Watkins S, Zoltan Berger F y Jaime Rappoport S.|
Background: Digestive refeeding in acute pancreatitis represent a dificult issue. It requires the rsolution of intestinal ileus and carriesa risk of reactivation. Aim: To evaluate criteria that may guide in early refeeding avoiding unnecesary prolonged fasting. Patients and methods: Thirty patients with acute pancreatitis were evaluatedin a prospective trial. The severity of the pancreatitis was evaluated according to APACHE II score and Balthazar CT scan altertions. The criteria proposed to start early refeeding were abscence ofnausea and vomiting, decreased abdominal pain, presence of bowel sounds and lowering of serum amylase levels. Balthazar CT scan clasification, was used to decide between oral or enteral refeeding.Results. Eighty percent of patients had alterations in pancreatic density, necrosis or pancretic or peripancreatic liquid collections in the CT scan (correspondig to Balthazar stages C,D,or E). Tenpatients fullfilled the criteria for enteral refeeding at 8.1 ± 3.5 days (range 3 to 15 days), and 21 patients fulfilled criteria fo enteral refeeding at 8.7±4.5 (range 4-19). No patient had a reactivation...