[Enteral nutrition through long-term jejunostomy]

Area of Science:

• Gastroenterology and Surgical Oncology

Background:

• Subtotal gastrectomy is a common procedure for gastric neoplasms.
• Lesser curvature necrosis is a rare but severe complication post-gastrectomy.
• Esophageal and gastric stump involvement necessitates aggressive surgical management.

Observation:

• A female patient developed peritonitis following subtotal gastrectomy for gastric neoplasm.
• Necrosis extended from the lesser curvature to the anterior esophageal wall.
• Further surgery included esophageal and gastric stump transection, cervical esophagostomy, and needle catheter jejunostomy for feeding.

Findings:

• The patient required a jejunostomy for long-term nutritional support due to unreconstructable GI tract post-surgery.
• Reconstruction was precluded by tumoral infiltration of the colon and tumor recurrence.
• The jejunostomy feeding technique was utilized for 187 days without complications.

Implications:

• Cervical esophagostomy and jejunostomy can be a safe and effective long-term feeding solution when GI reconstruction is not feasible.
• This case highlights an uncommon but critical surgical complication and its management.
• Highlights the potential for long-term use of needle catheter jejunostomy in complex oncological cases.