Mangelernährung bei maligner intestinaler Obstruktion

Abstract

A reduced nutritional state in cancer patients is associated with an unfavourable prognosis, can increase morbidity or be the primary cause of death in patients with progressed disease. Furthermore malnutrition can be the cause of additional hospitalisation. For the diagnosis of malnutrition there are simple assessments, e. g. the Nutritional Assessment SGA (Subjective Global Assessment; Detsky et al) available. If malnutrition is diagnosed, a specific nutritional therapy should be initiated after obtaining informed consent. Whenever possible, the enteral route should be preferred. In case of malignant intestinal obstruction this is often not possible, which leaves parenteral nutrition as the only choice. Currently available data indicate that especially patients, whose estimated life expectancy is three months or more and whose Karnofsky-Index is above 50 or whose Performance Status is above 2, profit from total parenteral nutrition. We report on a patient with advanced GI-cancer and bowel obstruction who developed malnutrition. Nutrition of advanced cancer patients and their limitations are discussed in a case report on a patient with advanced GI-cancer.