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March 1973

Protracted Diarrhea of Infancy Treated by Intravenous Alimentation: I. Clinical Studies of 16 Infants

Author Affiliations

From the departments of medicine (Drs. Lloyd-Still and Shwachman) and surgery (Dr. Filler), the Children's Hospital Medical Center and the departments of pediatrics and surgery, Harvard Medical School, Boston.

Am J Dis Child. 1973;125(3):358-364. doi:10.1001/archpedi.1973.04160030032006

Sixteen infants with protracted diarrhea and resultant nutritional failure were treated with intravenous alimentation for periods of 20 to 98 days (mean, 43 days). All infants survived the immediate illness. A variety of enteropathogenic microorganisms were isolated from the stools of seven of 16 infants. Protracted diarrhea in infancy involves a wide variety of lesions affecting any portion of the intestinal tract from the duodenum to the rectum. Intravenous alimentation was effective in correcting the severe nutritional deficiencies in all, although two with chronic inflammatory bowel disease and one with intestinal lymphangiectasia also required surgery. Thirteen of the 16 patients thrived on a commercial formula after intravenous alimentation was initiated. Five patients developed catheter sepsis and recovered with removal of the catheter and antibiotic therapy. Although intravenous alimentation is life-saving, the procedure carries well-defined risks and should not be undertaken unless conservative measures have failed.

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