Transgastric jejunal snare technique facilitates primary jejunostomy placement

Placement of percutaneous jejunostomy tubes using fluoroscopy may be technically challenging because of the peristaltic motion of small bowel loops within the peritoneum. Furthermore, fluoroscopic jejunostomy placement has an inherent risk of complications, including peritonitis and death. A transnasal snare technique to facilitate direct jejunostomy in patients with a surgically altered gastric anatomy has been previously reported. This report describes a patient with gastroparesis and a chronic nasojejunal tube who underwent a percutaneous transgastric snare technique to facilitate the placement of a direct jejunostomy.