Closed-bowel Loop Obstruction-An Unusual and Forgotten Complication of Feeding Jejunostomy: Case Report

Area of Science:

• Gastroenterology
• Surgical Complications
• Abdominal Surgery

Background:

• Feeding jejunostomy (FJ) is a common procedure for enteral nutrition in patients unable to tolerate oral intake.
• While generally safe, FJ can lead to various complications, including mechanical, infective, and metabolic issues.
• Closed-bowel loop obstruction is an exceptionally rare complication associated with FJ.

Observation:

• A case report details a 67-year-old male patient who developed closed-bowel loop obstruction post-FJ.
• The FJ was performed for enteral access in the context of locally advanced gastroesophageal junction carcinoma.
• The patient presented with abdominal distension, necessitating emergency laparotomy to prevent gastric ischemia and perforation.

Findings:

• The patient underwent a redo FJ procedure after the emergency laparotomy.
• Postoperative recovery following the redo FJ was uneventful.
• This case highlights the potential for rare complications even after standard surgical procedures.

Implications:

• Surgeons must maintain a high index of suspicion for rare complications like closed-loop obstruction in patients presenting with upper abdominal pain and distension post-FJ.
• Early recognition and intervention are crucial to prevent severe outcomes such as gastric ischemia and perforation.
• This case underscores the importance of considering unusual diagnoses in the postoperative management of patients with feeding jejunostomy.