Hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutide

Abstract Introduction: teduglutide (TED) is indicated for the treatment of patients with short-bowel syndrome (SBS) who are dependent on parenteral support. Case report: we report the case of a 60-year-old woman with SBS treated with TED. She had previously undergone multiple surgical resections due to Crohn's disease. Her remnant bowel included only the duodenum and 50-60 centimeters of jejunum. The patient was dependent on intravenous fluids (2,320 mL/48 h) and had a high stoma output (3,000 mL/day). After four months of TED the jejunostomy output had decreased to 2,200 mL/day with a thicker consistency, and intravenous fluid therapy was reduced to 2,010 mL/48 h. TED was withdrawn due to acute pancreatitis and enlargement of two supraumbilical hernias with high strangulation risk. Discussion: pancreatitis has been reported in clinical studies, and determination of amylase and lipase is recommended in all patients receiving TED. In contrast, there are no recommendations for the surveillance of hernia enlargement in patients on TED therapy, but we suggest the need for surveillance based on this case report.

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Main Authors: Conejo,Irene, Mas-Malagarriga,Núria, Riera,Pau, Cardenete,Joana, Puig-Piña,Rocío, Rodríguez,Manuel, Pourcq,Jan T de
Format: Digital revista
Language:English
Published: Grupo Arán 2022
Online Access:http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112022000100027
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spelling oai:scielo:S0212-161120220001000272022-03-30Hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutideConejo,IreneMas-Malagarriga,NúriaRiera,PauCardenete,JoanaPuig-Piña,RocíoRodríguez,ManuelPourcq,Jan T de Teduglutide Short bowel syndrome Pancreatitis Hernia enlargement Case report Abstract Introduction: teduglutide (TED) is indicated for the treatment of patients with short-bowel syndrome (SBS) who are dependent on parenteral support. Case report: we report the case of a 60-year-old woman with SBS treated with TED. She had previously undergone multiple surgical resections due to Crohn's disease. Her remnant bowel included only the duodenum and 50-60 centimeters of jejunum. The patient was dependent on intravenous fluids (2,320 mL/48 h) and had a high stoma output (3,000 mL/day). After four months of TED the jejunostomy output had decreased to 2,200 mL/day with a thicker consistency, and intravenous fluid therapy was reduced to 2,010 mL/48 h. TED was withdrawn due to acute pancreatitis and enlargement of two supraumbilical hernias with high strangulation risk. Discussion: pancreatitis has been reported in clinical studies, and determination of amylase and lipase is recommended in all patients receiving TED. In contrast, there are no recommendations for the surveillance of hernia enlargement in patients on TED therapy, but we suggest the need for surveillance based on this case report.Grupo AránNutrición Hospitalaria v.39 n.1 20222022-02-01journal articletext/htmlhttp://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112022000100027en
institution SCIELO
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country España
countrycode ES
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access En linea
databasecode rev-scielo-es
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region Europa del Sur
libraryname SciELO
language English
format Digital
author Conejo,Irene
Mas-Malagarriga,Núria
Riera,Pau
Cardenete,Joana
Puig-Piña,Rocío
Rodríguez,Manuel
Pourcq,Jan T de
spellingShingle Conejo,Irene
Mas-Malagarriga,Núria
Riera,Pau
Cardenete,Joana
Puig-Piña,Rocío
Rodríguez,Manuel
Pourcq,Jan T de
Hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutide
author_facet Conejo,Irene
Mas-Malagarriga,Núria
Riera,Pau
Cardenete,Joana
Puig-Piña,Rocío
Rodríguez,Manuel
Pourcq,Jan T de
author_sort Conejo,Irene
title Hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutide
title_short Hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutide
title_full Hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutide
title_fullStr Hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutide
title_full_unstemmed Hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutide
title_sort hernia enlargement and pancreatitis in a patient with short bowel syndrome treated with teduglutide
description Abstract Introduction: teduglutide (TED) is indicated for the treatment of patients with short-bowel syndrome (SBS) who are dependent on parenteral support. Case report: we report the case of a 60-year-old woman with SBS treated with TED. She had previously undergone multiple surgical resections due to Crohn's disease. Her remnant bowel included only the duodenum and 50-60 centimeters of jejunum. The patient was dependent on intravenous fluids (2,320 mL/48 h) and had a high stoma output (3,000 mL/day). After four months of TED the jejunostomy output had decreased to 2,200 mL/day with a thicker consistency, and intravenous fluid therapy was reduced to 2,010 mL/48 h. TED was withdrawn due to acute pancreatitis and enlargement of two supraumbilical hernias with high strangulation risk. Discussion: pancreatitis has been reported in clinical studies, and determination of amylase and lipase is recommended in all patients receiving TED. In contrast, there are no recommendations for the surveillance of hernia enlargement in patients on TED therapy, but we suggest the need for surveillance based on this case report.
publisher Grupo Arán
publishDate 2022
url http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112022000100027
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