Parenteral nutrition through the venous port system in patients with short bowel syndrome (literature review and clinical case)

   Introduction. Short bowel syndrome is a rare disease that occurs after the removal of a large part of the small intestine or due to developmental abnormalities in the embryonic period. Such patients need long-term treatment, the vital component of which is parenteral nutrition (PN). PN requires constant vascular access, the problem of choosing which is always an urgent topic due to the risks of various complications. The venous port system is the optimal type of vascular access for PN due to the low level of intraoperative and postoperative complications and ease of operation.

   The aim of the study is to present a clinical case of venous port system implantation and its use as a vascular access for PN of a patient with short bowel syndrome.

   Clinical case. Patient G., 30 years old, with a diagnosis: “Condition after appendectomy on 24.03.2023, laparotomy, adhesiolysis on 30.04.2023. Condition after 9 sanitation relaparotomies for
tertiary peritonitis. Short bowel syndrome (distal): resection of the distal ileum for small intestinal perforations with the formation of a high jejunostomy at a distance of 90 cm from the ligament of Treitz (residual process 90 cm). Intestinal failure type III, malabsorption syndrome stage 2, severe course. Severe protein-energy malnutrition. Hypoalbuminemia, hypoproteinemia”. Surgery was performed in the Clinics of Samara State Medical University: Implantation of the venous port system into the superior vena cava through the right internal jugular vein with the chamber located in the right
subclavian region. He was discharged for outpatient follow-up treatment in a stable condition with positive dynamics.

   Conclusions. The use of the venous port system as an access for PN in severe and asthenic patients with short bowel syndrome minimizes complications, effectively and conveniently provides PN.

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