The patient is admitted to the hospital and started on intravenous fluids
He undergoes esophago-gastro-duodenoscopy( EGD) the next day, where he is found to have a 6 cm nearly obstructing tumor in the lower esophagus, suspicious for a malignancy which is biopsied.
Pathology is consistent with esophageal adenocarcinoma and CT Chest/ Abdomen/ Pelvis shows several lung and liver metastasis.
He is started on glucose containing fluids and partial parenteral nutrition through a peripheral IV line.
Basic labs prior to initiating nutrition are shown below
The patient is scheduled for a repeat endoscopy with placement of an esophageal stent across the obstructing tumor 3 days later. He has significant relief of dysphagia after stent placement and is is able to drink liquids and eat soft solids. Family brings him his favorite foods, including a large carton of ice cream for dinner
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