Intestinal Dysmotility and the Risk of Volvulus Following Omega-Jejunostomy Tube Placement in Children

Area of Science:

• Pediatric surgery
• Gastroenterology
• Medical devices

Background:

• Gastric dysmotility often necessitates distal enteral feeding access in children.
• Traditional methods like nasoduodenal and gastrojejunostomy tubes have high dislodgement rates, leading to hospital visits and radiation exposure.
• The omega-jejunostomy (OJ) tube was developed to simplify tube changes after tract maturation, but its use is not well-characterized.

Purpose of the Study:

• To examine patient factors and outcomes associated with omega-jejunostomy (OJ) tube placement in pediatric patients.
• To assess the incidence of complications, including intestinal volvulus, reoperations, emergency department (ED) visits, and readmissions following OJ-tube placement.

Main Methods:

• Retrospective cohort study of 23 pediatric patients who underwent OJ-tube placement between 2016 and 2024.
• Analysis of demographic, perioperative, and outcome data.
• Specific focus on volvulus incidence, ED visits, and readmissions.

Main Results:

• Intestinal volvulus occurred in 17.4% of patients, requiring emergent laparotomy and associated with longer hospital stays and higher 30-day readmission rates.
• Patients with volvulus had a higher incidence of underlying intestinal dysmotility (75%).
• Emergency department visits were frequent (73.9%), mainly due to clogged or dislodged tubes.

Conclusions:

• Omega-jejunostomy (OJ) tube placement is an effective feeding option but associated with significant risks, including volvulus and frequent ED visits.
• Intestinal dysmotility may predispose children to volvulus, highlighting the need for careful patient selection and monitoring.
• Improved caregiver education and management strategies for mechanical complications are needed to reduce ED utilization.