A. Nakad

Is early enteral nutrition in acute pancreatitis dangerous? About 20 patients fed by an endoscopically placed nasogastrojejunal tube.

Bowel rest during treatment of acute pancreatitis deprives the gut of nutrients and affects its structure and function. Enteral feeding is usually performed late in the course of acute pancreatitis and therefore cannot prevent intestinal barrier dysfunction and possible bacterial translocation. To assess the effect of early enteral nutrition we performed a prospective study on 21 patients (11 males/10 females) presenting with severe acute pancreatitis (13 biliary, 6 alcoholic, and 2 miscellaneous). Severity was established by a mean Ranson score of 3.57. All but one patient could be fed through a double-lumen nasogastrojejunal tube within 60 h after admission. No significant complication of the technique was observed. We conclude that early jejunal feeding can be used safely in severe acute pancreatitis. Further comparative studies are necessary to demonstrate any superiority to total parenteral nutrition.

Nodular Regenerative Hyperplasia Of The Liver And Esophageal Varices In Felty’S Syndrome: A Clinicopathologic Case Report With Review Of The Literature

SummaryNodular regenerative hyperplasia of the liver (NR.HL) is an uncommon entity of unknown origin and pathogenesis. If often occurs in association with various extrahepatic diseases such as Felty’s syndrome (FS). Because of the irregular distribution of nodules throughout the liver parenchyma the diagnosis most often relies on surgical, or post-mortem specimens. We report a case of FS with portal hypertension in which the diagnosis of FR1IL was made on the basis of routine diagnostic liver biopsy. The pathogenesis and treatment of the disease are discussed with respect to data in the literature.