A Surgical Conundrum in Feeding Jejunostomy–Jejunojejunal Intussusception: A Case Series

Abstract

Intussusception is a common cause of intestinal obstruction in the pediatric population. Usually, it is primary and benign and can be managed by nonoperative interventions in 80% of the cases. Adult intussusception accounts for only 5% of all cases of intussusception and 1%–5% of all cases of intestinal obstruction. Unlike in the pediatric population, intussusception in adults is usually caused by a pathologic lead point. The initial investigation to diagnose it is an ultrasound abdomen followed by contrast-enhanced computed tomography (CECT) of the abdomen. The placement of an intestinal tube for feeding purposes has been rarely reported as a cause of intussusception. Here, we present a case series of four patients who had jejunojejunal intussusception following the placement of feeding tubes into the jejunum. Three patients were operatively managed and one was managed conservatively.

Two Episodes of Retrograde Jejunogastric and Jejunojejunal Intussusceptions as a Complication of Gastrostomy Tube in a Child: A Case Report

“…Different theories have been proposed for intussusception caused by the placement of feeding tubes [6]: The possible mechanisms of our case's first episode probably associated with distal tip and balloon migrated into small bowel causing vomiting from small bowel obstruction. The migrated balloon also served as the leading point to retrograde jejunal peristalsis.…”

Jejunal intussusception on jejunostomy tube: A rare cause of occlusion in adults

“…However, these measures are limited to patients without any signs of severity or who have a high risk of developing a cancer related to short bowel syndrome. The surgical treatment remains, by and large, the first-choice treatment, as Wu et al recommended surgery for all cases with signs of obstruction [13] .…”

A feeding jejunostomy causing an intussusception – case report and literature review

“…Some report that intussusception is more likely to occur when the feeding tube is farther away from the anastomosis, with a shorter JT causing the intestines to shrink over the tube, or with enteral formulas with low pH [ 8 ]. Some evidence suggests that intussusception is more frequent with larger tubes, with a distant tip acting as a leading point [ 9 ]. Some suggest that GT balloons are culprits.…”