Recognizing the impact of malnutrition and sustained enteric output, the clinical team implemented TPN per ASPEN guidelines and planned to postpone surgical intervention until her albumin rose to >2.2 g/dL. Emerging literature now suggests that enteral nutrition, instead of TPN, may be feasible in select cases, an avenue warranting further exploration for the management of this patient. Here, ALB is linked to nutritional deficiency disease.