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Updated: Jan 19, 2026

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[Long-term home parenteral nutrition using a totally implanted cannulation system].

M Andĕl1, K Filip, P Brůcek

  • 1II. interní klinika 3. lékarské fakulty Univerzity Karlovy, Praha.

Casopis Lekaru Ceskych
|July 10, 1992
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Summary

This case study shows that long-term home parenteral nutrition can effectively manage severe Crohn's disease complications like rectal stenosis and fistulas. The patient experienced significant symptom improvement and maintained good health, demonstrating the viability of this treatment approach.

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Area of Science:

  • Gastroenterology
  • Clinical Nutrition
  • Surgical Case Reports

Background:

  • Crohn's disease, a chronic inflammatory bowel condition, can lead to severe anorectal complications such as stenosis and fistulas.
  • Complete nutritional support via the parenteral route (intravenous feeding) is an option for patients unable to maintain adequate oral intake.
  • The use of totally implanted central venous access devices facilitates long-term home parenteral nutrition.

Observation:

  • A 29-year-old male with severe Crohn's disease and rectal complications received complete parenteral nutrition for 15 months, including 13 months at home.
  • A totally implanted port system (Implantofix, Braun Co.) was utilized for long-term intravenous access.
  • The patient reported feeling well, maintained employment, and experienced cessation of fistula discharge within four weeks.

Findings:

  • After 15 months of exclusive parenteral nutrition, a significant improvement in rectal stenosis was observed.
  • All monitored laboratory parameters, including complete blood count, liver function tests, renal function, and electrolytes, remained within normal limits throughout the treatment period.
  • The patient achieved a modest weight gain of 1 kg over the 15 months.

Implications:

  • This case highlights the potential of long-term domiciliary parenteral nutrition as a therapeutic strategy for complex Crohn's disease patients with severe anorectal manifestations.
  • The successful application in an ambulatory setting suggests that home-based intravenous feeding can be a safe and effective alternative to hospitalization for selected patients.
  • This represents the first documented instance of ambulatory domiciliary parenteral nutrition use in Czechoslovakia for such a condition, expanding treatment possibilities.