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Small bowel ischemia: a consequence of feeding jejunostomy?
Southern Medical Journal
|February 1, 1986
Summary
Continuous jejunal feeding via needle catheter jejunostomy can lead to serious small bowel infarction, particularly in hypotensive patients. This feeding method may increase gut susceptibility to hypoperfusion.
Area of Science:
- Gastroenterology
- Surgical Nutrition
- Vascular Surgery
Background:
- Continuous jejunal feeding using needle catheter jejunostomy is a common method for nutritional support.
- This feeding route is generally considered safe with low complication rates.
- Small bowel ischemia or infarction has not been previously associated with jejunal feeding.
Observation:
- Five patients with jejunal feeding experienced hypotension and abdominal distention.
- All patients had normal small bowel at the time of jejunostomy insertion.
- No mechanical obstruction or major vascular occlusion was identified during exploration.
Findings:
- Two patients developed jejunal infarction.
- Three patients experienced infarction of the entire small bowel.
- Hypotension during jejunal feeding appears to be a critical factor.
Implications:
- Patients at risk for hypoperfusion may not tolerate continuous jejunal feeding.
- Jejunal feeding might increase the gut's susceptibility to reduced blood flow.
- Further investigation is needed to understand the mechanism linking jejunal feeding and ischemia.