Title: Outcome of management of high output fistulas in Abdominal Surgeries with Re-feeding: An observational study, Tertiary care Hospital, Jaipur
Authors: Dr Naina Kumar Agarwal, Dr Richa Jain, Dr Monika Rathore
DOI: https://dx.doi.org/10.18535/jmscr/v8i4.83
Abstract
Background: To find out the proportion of cases with successful outcome in patients of high output fistulas put on re-feeding along with additional nutrients in first four months.
Methods: This observational study was conducted at a tertiary care hospital. Re-feeding formula prepared in ratio of 1:10 and given with every Re-feed. Ingredients of re feed: Coconut water 50 ml, Salt and sugar: 1 tsp each, 2 Eggs, Vitamin B and iron syrup:1Tsp each, Protein powder 50 grams, Honey 2 tsp, Ghee 1tsp. Cases monitored till the stoma was closed.
Results: Majority (75%) survived during study period. Three out of five died during hospital stay and two after discharge. Seventeen patients required post operative ICU care. Majority (85%) of survivors had normal level of Vitamin B, Ferritin and electrolytes after 15 days. Ten patients required readmission for acute renal failure and managed conservatively. Additional PN was required in 10 patients.
Conclusion: Patients with proximal jejunostomies could be alternatively managed with distal Re-feeding with addition of nutrients. Majority recovered after one month of re-feeding. Mortality low.
Keywords: Outcome, Abdominal Surgeries, Re-feeding.
