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Inicio Cirugía y Cirujanos (English Edition) Pregnancy and short bowel syndrome treated with parenteral nutrition
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Vol. 84. Issue S1.
Pages 3-8 (May 2016)
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Vol. 84. Issue S1.
Pages 3-8 (May 2016)
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Pregnancy and short bowel syndrome treated with parenteral nutrition
Embarazo y síndrome de intestino corto tratado con nutrición parenteral
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José Antonio Carrasco-Rojasa, Jesús Tapia-Juradob, Lionel Leroy-Lópezc, Jorge Ruíz-Lizarragaa
a Department of Surgery, Hospital Angeles del Pedregal, Mexico City, Mexico
b Chief of Surgery, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
c Coordinator of Obstetrics and Gynaecology, Nacional 20 de Noviembre Medical Centre, Social Security Institute Serving State Workers, Mexico City, Mexico
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Antecedentes: La nutrición parenteral total ha mejorado la sobrevida de los pacientes con síndrome de intestino corto; sin embargo, se ha empleado en pacientes con embarazo en pocas ocasiones.
Caso clínico: Se presenta el caso de una paciente de 32 años de edad, con embarazo de 22 semanas de gestación, que requirió resección masiva de 4 m de intestino delgado por torsión mesentérica. No presentó complicaciones quirúrgicas durante el postoperatorio inmediato ni efectos adversos sobre el producto. Se manejó con nutrición parenteral durante 105 días, con cambios metabólicos en el perfil de lípidos de la madre, sin otros cambios de importancia. La composición de las soluciones de nutrición parenteral se manejó con lípidos, como aporte calórico no proteico.
El producto fue controlado ultrasonográficamente sin cambios en su desarrollo. Al nacimiento, presentó hipertensión arterial secundaria a reflujo vesicoureteral, que se resolvió satisfactoriamente con tratamiento.
Conclusiones: La presentación de este caso demuestra la eficacia del manejo del síndrome de intestino corto en una paciente embarazada, sin alteraciones en su evolución gestacional ni afectación para el producto.
 

Palabras clave:
Nutrición parenteral; Síndrome de intestino corto; Isquemia intestinal; Embarazo

Background: Total parenteral nutrition has improved the survival of patients with short bowel syndrome; however, it has been used infrequently in pregnant patients.
Clinical case: We present the case of a 32-year-old woman who was 22 weeks pregnant at the time of admission and required a massive resection of 4 m of small intestine due to mesenteric torsion. The patient did not present surgical complications during the immediate post-operative period and there were no adverse effects on the foetus. Management with parenteral nutrition was carried out for 105 days, showing metabolic changes in the lipid profile of the mother without any other significant changes. The composition of solutions for enteral nutrition was managed with lipids as non-protein caloric intake.
The foetus was monitored by ultrasonography with no change in its development. The newborn presented arterial hypertension secondary to vesicoureteral reflux, which was successfully resolved with treatment.
Conclusions: The presentation of this case demonstrates the effectiveness of the management of short bowel syndrome in a pregnant patient without changes in gestation evolution.

Keywords:
Parenteral nutrition; Short bowel syndrome; Intestinal ischemia; Pregnancy
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