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Jejunal perforation caused by a feeding jejunostomy tube: a case report

Nicholas A Stylianides1, Ravindra S Date, Kishor G Pursnani

  • 1Department of Gastrointestinal Surgery, Lancashire Teaching Hospital NHS Foundation Trust, Preston Road, Chorley, Lancashire, UK. nickstylianides@hotmail.com

Journal of Medical Case Reports
|July 2, 2008
PubMed

Insights

A rare complication of feeding jejunostomy tubes is jejunal perforation, which can lead to sepsis. Early diagnosis and intervention are crucial in neurologically impaired patients receiving long-term nutritional support.

Area of Science:

  • Gastroenterology
  • Surgical Complications
  • Nutritional Support

Background:

  • Percutaneous endoscopic gastrostomy (PEG) and feeding jejunostomy (FJ) tubes provide long-term nutritional support for patients with neurological disorders.
  • Mechanical complications associated with these feeding tubes are a known concern.

Purpose of the Study:

  • To report a case of jejunal perforation following a feeding jejunostomy tube placement.
  • To highlight the importance of prompt diagnosis and management of tube-related complications in neurologically impaired patients.

Main Methods:

  • A 17-year-old male with cerebral injury underwent a percutaneous endoscopic gastrostomy tube exchange to a feeding jejunostomy tube.
  • The patient developed sepsis 24 hours post-procedure. Diagnostic imaging, including contrast study and CT scan, was initially inconclusive.
  • Laparotomy revealed jejunal perforation by the feeding tube.

Main Results:

  • The feeding jejunostomy tube had perforated the jejunal wall, with the tip lying outside the lumen.
  • The perforation and previous insertion site were surgically managed, and a new feeding jejunostomy tube was placed distally.
  • The patient's condition was successfully treated.

Conclusions:

  • Neurologically impaired patients with feeding tubes are at risk for serious complications like jejunal perforation.
  • A low threshold for contrast studies and surgical intervention is recommended to prevent delayed treatment of tube-related issues.
Abstract

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