Early Enteral Nutrition Tolerance in a Duodenal Fistula Patient Undergoing Open Abdomen with Vacuum-assisted Temporary Abdominal Closure.

This case sought to manage a duodenal fistula patient who underwent an open abdomen with vacuum-assisted temporary abdominal closure (VAC) by evaluating his tolerance to early enteral nutrition therapy (ENT). A review of the patient suggested that he developed an abdominal infection as a result of a high duodenal fistula, which necessitated an open abdomen and VAC. Prior to the initiation of ENT, the patient had a patient-generated subjective global assessment (PG-SGA) score of 8 (1st day) suggesting the need for nutritional intervention. Upon ENT intervention, the patient's PG-SGA score dropped to 2 (30th day) indicating an improvement in the nutritional status, probably due to measures such as formulation, implementation, and management of early ENT. The improved nutritional status of the patient led to the success of duodenal fistula repair and abdominal wall defect reconstruction within a short time, thus ensuring a successful surgery. Key Words: Duodenal fistula, Open abdomen, Enteral nutrition.