Use of total parenteral nutrition as a “Medical colostomy” in management of severe lacerations of the sphincter

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Abstract
A case of anal-sphincter injury with total fecal incontinence is presented. The use of total parenteral nutrition (TPN) as a medical colostomy is stressed. After 4 wk of support by TPN, the perineal wound had healed and successful sphincteroplasty was performed. TPN was used in the postoperative period to delay bowel movements for 1 wk. The general concept of the use of TPN in sphincter injury is presented, giving the surgeon an option in management of these injuries without resorting to a preliminary colostomy.

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