Superior mesenteric artery syndrome in a child with acute gastric dilatation with refractory Guillain-Barré syndrome.

Superior Mesenteric Artery Syndrome (SMAS) resulting from proximal partial small bowel obstruction is one of possible causes of acute gastric dilatation (AGD). A child with refractory demyelinating Guillain-Barré syndrome which received 5 times IVIG and consequently 5 times plasmapheresis intubated until 59th day of admission. Because of complicated treatment and cardiopulmonary resuscitation (CPR) nutrition was completely neglected which lead to severe SMAS because of weight loss. Gradual advancements of continuous enteral and parenteral nutrition improved patient's symptoms significantly. Hypophosphatemia complicated the weaning from ventilator which after nutrition therapy resolved and patient extubated. Present case is the first report of pediatric demyelinating GBS suspected to SMAS.

Malnutrition and medical nutrition therapy in hospitalized children: a case study of using national malnutrition screening tools in northeastern Iran.

BACKGROUND: Nationwide studies have focused only on prevalence of malnutrition in hospitalized children, while medical nutrition therapies and assessing nutritional interventions is neglected. METHODS: This research was conducted in tertiary level children hospitals in the NorthEastern region of Iran for 1 year from 2016 to 2017. Five questions were included in the initial assessment form and, if there was even one positive response, nutritional interventions were prescribed for the patients. RESULTS: A total of 65 children aged ≥ 5 years and hospitalized for ≥ two days were included. 24.6% of patients had 2 >BMI Z-score>-2 at time of admission. At the beginning of the study, weight loss more than 10%, and appetite loss or decreased food intake was observed in 10.8% and 20% of the study population, respectively. Median BMI percentile of patients with nutritional intervention was 8.9 (0.1-98.7) at the beginning of the study and 12.7 (0.1-98.4) at discharge time which shows a significant difference (P=0.01). CONCLUSION: Medical nutrition therapy employed in this study prevented deterioration of nutritional status of children during hospitalization and was effective in stabilizing indices of nutritional status.