Q: What is the best place for feeding tube to be at during management of acute pancreatitis?


Answer:  Jejunum

In pancreatitis, jejunal feed is preferred as it minimize the stimulation of pancreatic exocrine secretions. Ideally, in ICU patients, position of post-pyloric feeding tube is beyond the ligament of Treitz. It does not mean that patients can't be feed in gastric or earlier parts of duodenum. Risks and benefits should be considered as enteral feed is vital for prevention of sepsis in ICU patients.


Reference:

1. McClave SA, Chang WK, Dhaliwal R, Heyland DK. Nutrition support in acute pancreatitis: a systematic review of the literature. JPEN J Parenter Enteral Nutr 2006; 30:143.