Case Report
Case Report on Nutrition Management in Pseudomyxoma Peritonei (Peritoneal Carcinomatosis with Low Grade Appendical Mucinous Neoplasm)
Arvind S* and Mullachery A
Department of Dietetics, Fortis Hospital, Bangalore, Karnataka, India
*Corresponding author: Arvind Shalini, Department of Dietetics, Fortis Hospital, Bangalore, Karnataka, India. E- mail Id: shalini.arvind@fortishealthcare.com
Article Information:Submission: 29/06/2026; Accepted: 27/07/2026; Published: 30/07/2026
Copyright: ©2026 Arvind S, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Pseudomyxoma peritonei is a rare mucin-producing malignancy characterized by progressive abdominal distension and poor oral intake. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy remains the standard treatment; however, perioperative malnutrition significantly impacts outcomes. This case highlights the role of individualized medical nutrition therapy in optimizing recovery.
Materials and Method: A 68-year-old male diagnosed with Pseudomyxoma peritonei underwent nutritional assessment using Subjective Global Assessment. A tailored nutrition plan was implemented, including preoperative carbohydrate loading, perioperative total parenteral nutrition and stepwise progression to oral feeding. Nutritional intake, biochemical markers, and clinical tolerance were monitored throughout hospitalization under a multidisciplinary approach.
Results: The patient presented with severe nutritional risk, hypoalbuminemia, anaemia and poor oral intake. Preoperative carbohydrate loading was successfully administered as per Enhanced Recovery After Surgery protocol. Due to persistent intolerance, total parenteral nutrition was initiated and gradually increased to meet requirements. Postoperatively, the patient remained nil per oral for 48 hours, followed by gradual reintroduction of oral intake alongside total parenteral nutrition. Diet progression from liquids to semisolids and soft high-protein foods was well tolerated. Improvement in gastrointestinal function, clinical stability, and dietary intake was observed, allowing discontinuation of total parenteral nutrition prior to discharge.
Conclusion: Early, individualized nutritional intervention, including perioperative total parenteral nutrition support and gradual diet advancement, played a crucial role in improving nutritional status and recovery in a patient with Pseudomyxoma peritonei undergoing Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Continuous monitoring and multidisciplinary care are essential to reduce complications and enhance clinical outcomes.
Materials and Method: A 68-year-old male diagnosed with Pseudomyxoma peritonei underwent nutritional assessment using Subjective Global Assessment. A tailored nutrition plan was implemented, including preoperative carbohydrate loading, perioperative total parenteral nutrition and stepwise progression to oral feeding. Nutritional intake, biochemical markers, and clinical tolerance were monitored throughout hospitalization under a multidisciplinary approach.
Results: The patient presented with severe nutritional risk, hypoalbuminemia, anaemia and poor oral intake. Preoperative carbohydrate loading was successfully administered as per Enhanced Recovery After Surgery protocol. Due to persistent intolerance, total parenteral nutrition was initiated and gradually increased to meet requirements. Postoperatively, the patient remained nil per oral for 48 hours, followed by gradual reintroduction of oral intake alongside total parenteral nutrition. Diet progression from liquids to semisolids and soft high-protein foods was well tolerated. Improvement in gastrointestinal function, clinical stability, and dietary intake was observed, allowing discontinuation of total parenteral nutrition prior to discharge.
Conclusion: Early, individualized nutritional intervention, including perioperative total parenteral nutrition support and gradual diet advancement, played a crucial role in improving nutritional status and recovery in a patient with Pseudomyxoma peritonei undergoing Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Continuous monitoring and multidisciplinary care are essential to reduce complications and enhance clinical outcomes.