A Case of Chronic Intestinal Pseudo-Obstruction Managed With Percutaneous Endoscopic Transgastric Jejunostomy (PEG-J)

Chronic intestinal pseudo-obstruction (CIPO) is a rare, debilitating gastrointestinal motility disorder characterized by symptoms of intestinal obstruction in the absence of a mechanical cause. Although no definitive treatment currently exists, multidisciplinary therapies such as percutaneous endoscopic transgastric jejunostomy (PEG-J) for intestinal decompression have improved symptom control, enabled the partial resumption of oral intake, and facilitated a transition to outpatient management. We report the case of a 65-year-old woman who was diagnosed with CIPO following emergency surgery for a small bowel volvulus. Given her progressive symptoms requiring sustained intestinal decompression, PEG-J was placed. Intermittent decompression via PEG-J resulted in considerable symptom relief, the partial resumption of oral intake, and a reduced need for repeated hospitalization. Owing to high-output drainage of approximately 2,000 mL/day, home parenteral nutrition was initiated in combination with PEG-J, enabling a successful transition to home-based care.