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Intussusception Caused by Percutaneous Endoscopic Gastrostomy With Jejunal Extension in Patients With Severe Motor

Shin-Ichiro Hagiwara1, Takatoshi Maeyama1, Hitoshi Honma2

  • 1From the Department of Gastroenterology, Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.

JPGN Reports
|May 19, 2023
PubMed

Insights

Percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) is linked to a 23% risk of intussusception in patients with severe motor and intellectual disabilities (SMID). Lower BMI at PEG-J insertion may increase this risk.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Outcomes
  • Disability Medicine

Background:

  • Percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) is a common intervention for nutritional support in patients with severe motor and intellectual disabilities (SMID).
  • The specific risk of intussusception associated with PEG-J in this vulnerable population has not been well-established.
  • Understanding this risk is crucial for optimizing patient care and management.

Purpose of the Study:

  • To investigate the incidence and characteristics of intussusception in patients with SMID following PEG-J placement.
  • To identify potential risk factors associated with the development of intussusception in this cohort.
  • To inform clinical recommendations regarding the timing of PEG-J placement.

Main Methods:

  • A cross-sectional study involving a retrospective review of 26 patients with SMID who underwent PEG-J.
  • Data collection included patient demographics, clinical characteristics, and follow-up information.
  • Statistical analysis compared patients who developed intussusception with those who did not.

Main Results:

  • Six out of 26 patients (23%) developed intussusception after PEG-J placement.
  • The median time from PEG-J insertion to intussusception onset was 364 days.
  • Patients who developed intussusception had a significantly lower body mass index (BMI) at the time of PEG-J insertion compared to those who did not.

Conclusions:

  • Intussusception is a relatively frequent complication of PEG-J in patients with SMID.
  • Factors such as undernutrition and weight loss, potentially leading to deformity, may contribute to this risk.
  • Earlier consideration of enterostomy in patients with SMID receiving enteral nutrition via PEG-J may be warranted due to the identified risk.

Keywords:
enteral nutritionintussusceptionjejunal tube feedinglong-term use

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