PRESENTATION OF CASE
A 49-year-old man received postradiation therapy for squamous cell carcinoma of the cricopharyngeal area (T3 N1 M0). He had recently undergone pharyngectomy, laryngectomy, radical neck dissection on the right side of the neck, and closure of the pharynx with a right deltopectoral flap. Postoperatively, a fistula from the pharynx to the anterior aspect of the neck developed in the patient. One month postoperatively, the right carotid artery was ligated because of an impending rupture of it. After surgery, the patient did not do well medically. His weight dropped from 66.6 to 52.2 kg. The patient's hematocrit reading decreased to 25%, and the serum albumin level was reduced to 2.7 g/dL. He began to have persistent vomiting and diarrhea with his tube feedings.Because of ineffective alimentation, the patient received parenteral hyperalimentation. After an initial diuresis, the patient's weight increased from 52.2 to 57.6 kg in two weeks.
King AI. Current Status of Hyperalimentation. Arch Otolaryngol. 1979;105(6):369–372. doi:10.1001/archotol.1979.00790180067018
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