A 60-year-old patient with a history of esophageal carcinoma is undergoing treatment and is now experiencing significant difficulties with oral intake due to obstruction. The medical team considers various nutritional support options to ensure the patient receives adequate nutrition while managing their condition.
What is the most common indication for initiating parenteral nutrition?
A. Esophageal Carcinoma
B. Acute Diarrhea
C. Paralytic Ileus
D. Pyloric Stenosis
E. Massive Gut Resection
The Correct Answer is: E. Massive Gut Resection
Explanation:
– Massive Gut Resection (E): Parenteral nutrition is commonly indicated in cases where there is a massive gut resection. This situation results in the loss of a significant portion of the gastrointestinal tract, impairing nutrient absorption and necessitating intravenous nutritional support. It provides complete nutritional support when the gastrointestinal tract cannot be used for adequate nutrient absorption.
Explanation of Incorrect Options:
– Esophageal Carcinoma (A): While patients with esophageal carcinoma may require nutritional support, parenteral nutrition is not the first-line option. Enteral nutrition or feeding tubes are often preferred if the gastrointestinal tract is still functional.
– Acute Diarrhea (B): Acute diarrhea usually does not require parenteral nutrition unless it is severe and prolonged, and the patient cannot maintain adequate nutrition orally or enterally.
– Paralytic Ileus (C): Paralytic ileus is a temporary condition where the bowel is non-functional. While it may require temporary nutritional support, enteral nutrition is typically used when the bowel resumes function.
– Pyloric Stenosis (D): Pyloric stenosis, a condition where the pylorus is obstructed, often requires surgical intervention rather than parenteral nutrition. Nutritional support is usually managed enterally post-operatively.
In summary, massive gut resection is the most common indication for parenteral nutrition, making option E the correct answer.