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Parenteral nutrition via an arteriovenous bypass graft
  1. S M Turner1,
  2. C S J Probert1,
  3. P Lear2
  1. 1Department of Gastroenterology, Bristol Royal Infirmary, Marlborough St, Bristol, UK
  2. 2Department of Vascular Surgery, Southmead Hospital, Bristol, UK
  1. Correspondence to:
    Dr C Probert, Department of Gastroenterology, Bristol Royal Infirmary, Marlborough St, Bristol BS2 8HW, UK;
    C.S.J.Probert{at}bristol.ac.uk

https://doi.org/10.1136/gut.52.8.1218

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    Delivery of nutritional support via prolonged venous access can often pose a significant problem. We report a case of polytetrafluroethylene (PTFE) grafting from the axillary artery to the inferior vena cava (IVC) to provide parental nutrition to a young patient with intestinal failure.

    HISTORY

    A 19 year old woman was first admitted with non-specific abdominal pain. She repeatedly presented with recurrent small bowel obstruction thought to be secondary to inflammatory adhesions.

    In 1997, a Hartmann’s procedure was performed for a perforated distal sigmoid colon. Histology was suggestive of Crohn’s disease (CD). Over the next two years she was treated for CD. Once symptom free and without evidence of active CD she underwent subtotal colectomy with ileorectal anastomosis. Subsequent admissions with non-specific abdominal pain and weight loss failed to respond to steroid maintenance. Barium follow through showed slow small bowel transit with a lack of small bowel tonicity resulting in dilatation and no features of CD.

    Initial …

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