Non-occlusive small bowel necrosis during gastric tube feeding: a case report

Small bowel necrosis is known as a rare, but serious complication of jejuna l tube feeding. We report a case of non-occlusive small bowel necrosis with gastric tube feeding. The patient had a moderate multiple trauma with head injury. Abdominal distension developed after several days of uneventful na sogastric tube feeding. At laparotomy patchy necrosis of the small bowel wa s found without signs of bowel obstruction or impaired mesenteric perfusion . The patient recovered after a prolonged ICU stay. In this case the large doses of clonidine, given due to an alcohol withdrawal syndrome, were suspe cted to be a major contributing factor to the development of the small bowe l necrosis by impairing gut motility and mucosal perfusion. We conclude tha t, first, small bowel necrosis can occur after primarily uneventful enteral feeding, even with gastric feeding; second, clonidine can dramatically imp air gastrointestinal function in critically ill patients by impairing gut m otility and mucosal perfusion.