Traumatic Pancreatic Cutaneous Fistula: Comparison of Enteral and Parenteral Feedings

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Abstract
A patient with a gunshot injury to the duct of Wirsung in the pancreatic head developed a high-output pancreatic cutaneous fistula. Before operative repair, a 2-month period of nutritional support permitted a comparison of different feeding regimes. Elemental jejunal feedings containing 1-amino acids in a low-fat, hyperosmolar formula were associated with no greater fistula volume output than total parenteral nutrition. In addition to this efficacy in controlling pancreatic exocrine activity, elemental jejunal feedings were less than a third as expensive as parenteral nutrition.

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