IMPACT OF DISTAL ENTERAL RENUTRITION THERAPY ON WEIGHT GAIN IN A PATIENT WITH HIGH-OUTPUT ILEOSTOMY - A CASE REPORT

High-output ileostomies, especially those involving the small intestine, can impair patients' quality of life and result in electrolyte disturbances, particularly when they progress to high-output states1,2,3 Thus, intestinal transit reconstruction becomes an alternative to improving these patients' quality of life and clinical status. However, achieving an optimal nutritional state is essential for surgical treatment, as preoperative malnutrition is associated with poorer prognoses and severe postoperative complications4. Prehabilitation therapies can reduce postoperative complications by up to 50%5, along with other measures. This study aims to report the effect of ileostomy content reinfusion therapy in the preoperative period of intestinal transit reconstruction. The present work is an analytical case report that seeks to assess the impact of reinfused ileostomy content volume on weight gain in a patient with high-output ileostomy. The analysis was performed using RStudio version 4.4.0, testing the correlation between reinfused volume and weight, and between reinfused volume and BMI, using Pearson’s correlation test. The case involves a 66-year-old male diagnosed with colorectal cancer, initially undergoing rectosigmoidectomy and colectomy of the descending colon. Subsequently, the patient underwent exploratory laparotomy with enterectomy, ileostomy, and mucosal fistula creation due to a cavitary abscess involving the small intestine. Thirty-two days after the last surgery, the patient returned to the service with malnutrition, accompanied by asthenia, tremors, and anorexia. During hospitalization, partial parenteral nutrition was combined with reinfusion of ileostomy content through the mucosal fistula for 14 days. The ileostomy had an output greater than 1000 mL/day. A significant correlation was observed between reinfused volume and weight gain (p-value = 0.01805) and BMI (p-value = 0.01801). Considering the importance of preoperative nutritional therapy in surgical patients, particularly oncological and malnourished individuals, reinfusion therapy proved effective in this case. It facilitated weight gain and allowed for subsequent intestinal transit reconstruction without postoperative complications. Additionally, it reduced the risks and costs associated with prolonged parenteral nutrition, as highlighted in other studies3,4,6.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025