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Background <p>Managing pain in patients with incurable intestinal failure requires a multidisciplinary approach that addresses complex pharmacological and systemic challenges while navigating prognostic uncertainties.</p> Case presentation <p>This case report of gastrointestinal hypoganglionosis demonstrates the use of subcutaneous ketamine when conventional opioids fail due to intestinal malabsorption and dysmotility. Effective care required interdisciplinary collaboration, yet persistent discordance between the patient’s curative expectations and her life-limiting prognosis hindered timely advance care planning and community support transitions.</p> Conclusions <p>Prognostic uncertainty, compounded by the condition’s rarity, highlights the need for early palliative care integration in non-malignant conditions, to ensure that care goals align with patient and family priorities. The case report advocates for adaptable care models that bridge inpatient and community services, even amid prognostic ambiguity, to prevent fragmented care during critical transitions.</p>

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Pain management in a patient with intestinal failure in the palliative care setting: case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Adarsh Das,
  • Jayamangala Sampath Kondasinghe

摘要

Background

Managing pain in patients with incurable intestinal failure requires a multidisciplinary approach that addresses complex pharmacological and systemic challenges while navigating prognostic uncertainties.

Case presentation

This case report of gastrointestinal hypoganglionosis demonstrates the use of subcutaneous ketamine when conventional opioids fail due to intestinal malabsorption and dysmotility. Effective care required interdisciplinary collaboration, yet persistent discordance between the patient’s curative expectations and her life-limiting prognosis hindered timely advance care planning and community support transitions.

Conclusions

Prognostic uncertainty, compounded by the condition’s rarity, highlights the need for early palliative care integration in non-malignant conditions, to ensure that care goals align with patient and family priorities. The case report advocates for adaptable care models that bridge inpatient and community services, even amid prognostic ambiguity, to prevent fragmented care during critical transitions.