Percutaneous endoscopic gastrostomy with a jejunal port for severe hyperemesis gravidarum

Hyperemesis gravidarum affects up to 2% of pregnancies and is characterized by severe nausea and vomiting persisting beyond the 14th week of gestation with weight loss, dehydration, electrolyte imbalance and ketonuria. We present the case of a woman with severe, refractory hyperemesis gravidarum in whom treatment with a percutaneous endoscopic gastrostomy with a jejunal extension allowed improvement of symptoms, reversal of maternal weight loss and the delivery of a healthy infant. Review of the literature reveals only one other paper describing this treatment. In all three cases successful outcomes for both mothers and children are described. We propose that percutaneous endoscopic gastrostomy with a jejunal extension is a safe, effective and relatively cheap intervention for severe, refractory hyperemesis gravidarum.