A woman in her 40s with metastatic squamous cell carcinoma of the chest wall and anorexia nervosa presented to the emergency department with 4 weeks of fatigue and chronic poor oral intake. On examination, she was tachycardic (heart rate, 114 beats/min) with a body mass index (calculated as weight in kilograms divided by height in meters squared) of 16.4. Alopecia and muscle wasting were present. Laboratory analysis revealed a serum albumin level of 1.5 g/dL (reference range, 2.5-5.2 g/dL; to convert to grams per liter, multiply by 10), and prealbumin level of 10 mg/dL (reference range, 20-40 mg/dL; to convert to milligrams per liter, multiply by 10). She received a diagnosis of severe protein calorie malnutrition, was admitted to the hospital, and underwent placement of a percutaneous endoscopic gastrostomy tube on hospital day 3. Enteral formula feedings were initiated and tolerated. The next day, she developed 4 to 5 loose nonbloody bowel movements per day (baseline, 1-2 solid bowel movements per day) without fever, abdominal pain, or cramping.

一名四十多岁的患有转移性胸壁鳞状细胞癌和神经性厌食症的妇女因四周的疲劳和长期不良的口服摄入而向急诊科就诊。经检查，她的心动过速（心律，每分钟114次），体重指数（以千克为单位的体重除以以米为单位的身高的平方计算）为16.4。出现脱发和肌肉消瘦。实验室分析显示血清白蛋白水平为1.5 g / dL（参考范围2.5-5.2 g / dL；转换为克/升，乘以10），白蛋白前水平为10 mg / dL（参考范围20-40） mg / dL；转换为毫克/升，乘以10）。她被诊断出患有严重的蛋白质卡路里营养不良，被送进医院，并在医院第3天接受了经皮内镜胃造口术管的放置。开始并耐受肠内配方奶喂养。第二天，她每天出现4到5次散乱的非血性排便（基线，每天1-2次实性排便），而没有发烧，腹痛或痉挛。