Complications of needle catheter jejunostomy in 2,022 consecutive applications

Bowel Necrosis Associated With Early Jejunal Tube Feeding

“…4,[8][9][10][11][12][13][14][15] Four articles specified the total number of patients exposed to enteral feeding during the observation period; the incidence of feeding-related bowel ischemia varied between 0.14% and 3.5%, the lowest incidence being observed in the largest population. Mesenteric ischemia occurred in patients of any age (mean, 48 years) operated on either for abdominal trauma or for elective organ resection.…”

“…2006;141:701-704 E NTERAL FEEDING IS BELIEVED to diminish stress response, improve immunity and wound healing, and significantly reduce septic complications after major upper abdominal procedures and in the setting of multisystem trauma. [1][2][3][4] This most likely occurs by stimulating enterocyte growth, resulting in improved mucosal barrier function and decreased bacterial translocation. 5 Motility studies that document return of small bowel peristalsis within hours after laparotomy provide the theoretical support for early postoperative enteral nutrition.…”

Enteral feeding via jejunostomy as a cause of intestinal perforation and necrosis

“…The postoperative evolution was fatal, and the patient passed away a few weeks later due to septic shock of abdominal origin. Jejuno-Cath ® feeding has multiple complications on record: a) mechanical: accidental withdrawal, catheter obstruction (0.74%), migration to the abdominal cavity, enteroatmospheric fistulas (0.14%), ischemia (0.14%) and intestinal necrosis (0.2%); b) infectious: subcutaneous abscess, abdominal wall infection, pneumonia caused by contamination and aspiration of the enteral feeding; c) gastrointestinal: abdominal distension, colic, diarrhea, constipation, nausea or vomit; and d) metabolic: hypocalcemia (50%), hyperglucemia (29%), hydroelectrolytic and base-acid imbalance, hypoglycemia, hypercalcemia, hypo or hypernatremia, hypophosphatemia and hypomagnesemia (2,4,5). Some complications can be treated without removing the catheter, such as cellulitis and subcutaneous abscess.…”

“…It is performed when EF is expected to last for long periods of time (1)(2)(3)(4)(5). The introduction technique could be surgical, endoscopically guided, o radiologically guided (2,3).…”

“…A Foley catheter, Ryle tube, Kehr tube, and needle-catheter (Jejuno-Cath ® ) are usually used for this purpose (1). The Jejuno-Cath ® provides nutritional support to the surgical patient, and is routinely used in the supramesocolic compartment, trauma and oncologic procedures, as well as in malnourished patients (2,4).…”