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Related Experiment Videos

Poor results with percutaneous endoscopic jejunostomy.

J A DiSario1, P G Foutch, R A Sanowski

  • 1Gastroenterology Division, Carl T. Hayden Veterans Administration Medical Center, Phoenix, Arizona 85012.

Gastrointestinal Endoscopy
|May 1, 1990
PubMed
Summary

Percutaneous endoscopic jejunostomy (PEJ) feeding in malnourished patients resulted in severe complications, including aspiration and death. This enteral feeding method did not prevent aspiration and experienced high rates of catheter failure.

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Area of Science:

  • Gastroenterology
  • Clinical Nutrition
  • Medical Device Safety

Background:

  • Malnourished patients often require specialized enteral feeding methods.
  • Percutaneous endoscopic gastrostomy (PEG) placement can facilitate jejunal feeding.
  • The efficacy and safety of percutaneous endoscopic jejunostomy (PEJ) for preventing aspiration require evaluation.

Purpose of the Study:

  • To assess the outcomes of percutaneous endoscopic jejunostomy (PEJ) catheter placement in malnourished patients.
  • To determine if PEJ feeding prevents aspiration.
  • To identify the complication rates and catheter failure associated with PEJ.

Main Methods:

  • Twenty malnourished patients underwent percutaneous endoscopic gastrostomy (PEG) placement.
  • A percutaneous endoscopic jejunostomy (PEJ) catheter was subsequently passed through the PEG for direct small bowel alimentation.

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  • Patient outcomes, including aspiration events, mortality, and PEJ catheter complications, were meticulously documented.

    • Main Results:

    • Serious complications occurred in 95% of patients, with a 50% mortality rate.
    • Aspiration was the primary adverse event, responsible for all deaths; 67% of patients continued to aspirate despite PEJ.
    • PEJ tube failures were frequent (70%), attributed to occlusion, leakage, malposition, and mechanical issues, rendering the tube nonfunctional 18% of the time.

    Conclusions:

    • Enteral feeding via PEJ does not effectively prevent aspiration in malnourished patients.
    • The PEJ technique is associated with high rates of morbidity (95%), mortality (50%), and catheter failure (70%).
    • Significant improvements in methodology and catheter design are necessary before recommending widespread use of PEJ.