Ornidazole in the treatment of liver dysfunction associated to long-term parenteral nutrition.

AIM: to reduction the TPN-related hepatic toxicity with an anaerobicidal th erapy (ornidazole in our case). PATIENT: a 24-year-old male surgically treated for intestinal occlusion. He had been treated with abdominal radiotherapy for rabdomyosarcoma of embryo nic urogenital sinus when he was five months old. It was found a great abdo minal radiotherapy sequelae and occluded and perforated small-bowel loop th at was resected. Postoperative time developed pelvic abscess and reoperatio n was performed. Severe intraabdominal inflammatory-adhesive process was no ticed which included all the intestinal loops with multiple perforations. A ttempts to release this situation was unsuccessful and several anastomoses, with some loop exclusions and a diverting loop jejunostomy were performed. In postoperative period he developed an enterocutaneous fistula and TPN wa s initiated. Higher and higher hepatic marker values were detected suggesti ng a progressive hepatotoxicity. METHODS: anaerobicidal agent (ornidazole) and cyclic total parenteral nutri tion as a therapy design were prescribed. RESULTS: there were satisfactory showing a reduction in hepatic marker valu es (72.5% fall in alanine aminotransferase). CONCLUSIONS: bearing in mind that some theories suggest that total parenter al nutrition may cause atrophic changes in the gut mucosa so giving rise to bacterial translocation, this anaerobicidal treatment designed could be as sumed effective for attenuating TPN-related liver damage.