Immediate postoperative feeding following massive abdominal trauma--the catheter jejunostomy

Early postoperative feeding with an elemental diet has been successful in elective gastrointestinal surgery. This study was undertaken to evaluate whether elemental feedings were feasible through a catheter jejunostomy in patients suffering massive abdominal and retroperitoneal injuries. Eight patients had a combination of hepatic, upper gastrointestinal, and pancreatic injuries. A 16-gauge intercath was placed in the proximal jejunum, and the constant infusion of elemental diet begun at 12 to 18 hr postoperatively. Within 2 days the patients were receiving 2200 to 2400 cal/day and were maintained at this level for 5 to 22 days (average 11 days) before oral intake could be resumed. Body weight, lean muscle mass, and serum albumin were maintained during this period. Transferrin levels and total lymphocyte count improved during the elemental feedings. All patients eventually recovered completely. There were no gastrointestinal complications associated with the early feeding. Catheter jejunostomy can provide early nutritional support in patients with massive abdominal injuries.