An extremely rare case of feeding jejunostomy proceeding to intussusception

Nulukurthi, Taraka Krishna; Kutikuppala, LV Simhachalam; Kuchana, Sai Kiran; Găman, Mihnea‐Alexandru; Koirala, Sarun; Boppana, Sri Harsha

doi:10.1002/ccr3.7460

Cited by 1 publication

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References 12 publications

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“…This can result in invagination of the proximal bowel into the distal bowel accompanied by distal migration of the catheter tip. [ 8 , 9 ] Retrograde intussusception has also been suspected to be associated with the preceding distal migration of the catheter and its repositioning attempt. [ 7 ] Upon an attempt for repositioning, the distally migrated tip of the catheter can serve as a fishhook and initiate invagination of the distal bowel into the proximal bowel.…”

Section: Discussionmentioning

confidence: 99%

Retrograde jejunoduodenogastric intussusception associated with fully functioning nonballoon nasojejunal feeding catheter: A case report

Lee

2024

Medicine

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Rationale: Retrograde jejunoduodenogastric intussusception refers to invagination of distal small intestine into the stomach. It is extremely rare. It is often associated with displaced feeding catheter in which its balloon tip migrates past the gastric pylorus. The intussusception is triggered by retraction of migrated catheter. It is often accompanied by feeding intolerance or catheter malfunction. This report describes a distinctive case of retrograde jejunoduodenogastric intussusception associated with a fully functioning nonballoon nasojejunal tube. Patient concern: A 19-year-old female was presented with repeated vomiting and abdominal distension for 5 days. Diagnosis: An abdominal computerized tomography revealed retrograde jejunoduodenogastric intussusception causing air/fluid-filled gastric distension. Immediate endoscopic examination revealed a loop of small intestine, protruding through the pylorus. Progressed ischemia of the migrated small bowel loop was confirmed. Interventions: At laparotomy, a jejunal loop migrating into the duodenum and stomach at the level of the ligament of Treitz was noticed. After manual reduction of migrated bowel, 2 segmental resections of necrotic segment were performed. A feeding jejunostomy was constructed in the proximal jejunum. Outcomes: Enteral feeding through the surgically constructed feeding jejunostomy was started on the 5th operative day and the patient was discharged on the 16th postoperative day. Lessons: When a patient under tube feeding exhibits abrupt intractable gastroesophageal reflux with a sign of catheter migration, we must consider the possibility of catheter-related intussusception. Having a fully functioning feeding catheter with nonballoon tip does not preclude retrograde jejunoduodenogastric intussusception.

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Section: Discussionmentioning

confidence: 99%