A 62- year old woman undergoes a lysis of adhesions and bowel resection for small bowel obstruction secondary to radiation enteritis after treatment for ovarian cancer. A jejunostomy is placed to facilitate nutritional repletion. After how much time feedings can be started using elemental formulas?
|B||4 to 6 hrs|
a. The common purpose of an ostomy is to let a patient's intestinal contents get out past an obstruction in his large gut.
b. Occasionally,it is needed to make an ostomy in his small gut to let food and drink get in past an obstruction in his oesophagus.
c. If pt cannot feed himself by mouth, and needs building up, an alternative to total parenteral nutrition (which will probably be impossibly expensive) is to put a tube into his jejunum and feed him through that.
d. Feeding jejunostomies are seldom needed, but they can be life-saving: for example, when a suture line in an injured duodenum needs protecting.
e. To reduce the danger of a leak, introduce the tube into his gut through a long oblique track.
f. FEEDING JEJUNOSTOMY INDICATIONS. (1) An oesophageal obstruction which is correctable. (2) To protect a suture line in the duodenum following an injury. (3) To protect a suture line in the stomach which has leaked. (4) A pancreatic abscess
g. The feeding can be started within 6-8 hours as the bowel peristalsis is not much hampered in this short procedure