Case Reports in Gastroenterology
Published: June 2008
Colojejunal Fistula Resulting from a D-PEJ Feeding TubeZielinski M.D. · Cima R.R.Department of Colon and Rectal Surgery, Mayo Clinic College of Medicine, Rochester, Minn., USA
Robert R. Cima, MD Department of Colon and Rectal Surgery Mayo Clinic College of Medicine 200 1st St SW, Rochester, MN 55905 (USA) Tel. +1 507 284 9079, Fax +1 507 284 1794, E-Mail cima.robert@mayo.edu |
|
Abstract
Numerous procedures have been developed to provide adequate enteral nutrition to patients with gastrointestinal disorders. Previously, operative placement of a feeding gastrostomy or jejunostomy tube was the accepted means of gaining chronic enteral access. However, improved technology and experience with endoscopic techniques have quickly replaced primary operative placement of enteral access. Direct percutaneous endoscopic jejunostomy (D-PEJ) is a procedure that was designed to deliver enteral feeding solutions for patients with proximal disease after unsatisfactory results from percutaneous endoscopic gastrostomy tubes with jejunal extensions (PEG-J). As with any procedure, it is associated with complications. We present the first reported case of a colojejunal fistula resulting from a D-PEJ placement. While D-PEJ has been shown to be relatively safe, complications related to the inherent limitations of the procedure need to be considered when the patient experiences unusual post-procedure symptoms and worked up appropriately.
© 2008 S. Karger AG, Basel
Related Articles:
References
- Ponsky JL, Aszodi A: Percutaneous endoscopic jejunostomy. Am J Gastroenterol 1984;79:113–116.
- Fan AC, Baron TH, Rumalla A, et al: Comparison of direct percutaneous endoscopic jejunostomy and PEG with jejunal extension. Gastrointest Endosc 2002;56:890–894.
- Henderson JM, Strodel WE, Gilinsky NH: Limitations of percutaneous endoscopic jejunostomy. JPEN J Parenter Enteral Nutr 1993;17:546–550.
- Disario JA, Foutch PG, Sanowski RA: Poor results with percutaneous endoscopic jejunostomy. Gastrointest Endosc 1990;36:257–260.
- Wolfsen HC, Kozarek RA, Ball TJ, et al: Tube dysfunction following percutaneous endoscopic gastrostomy and jejunostomy. Gastrointest Endosc 1990;36:261–263.
- Shetzline MA, Suhocki PV, Worman MJ: Direct percutaneous endoscopic jejunostomy with small bowel enteroscopy and fluoroscopy. Gastrointest Endosc 2001;53:633–638.
- Cope C, Davis AG, Baum RA, et al: Direct percutaneous jejunostomy: Techniques and applications – ten years experience. Radiology 1998;209:747–754.
- Holmes JH 4th, Brundage SI, Yuen, et al: Complications of surgical feeding jejunostomy in trauma patients. J Trauma 1999;47:1009–1012.
-
Smith SE, Clancy TV: Colocutaneous fistula. A rare complication of percutaneous gastrostomy. N C Med J 1998;59:80–82.
- Yamazaki T, Sakai Y, Hatakeyama K: Colocutaneous fistula after percutaneous endoscopic gastrostomy in a remnant stomach. Surg Endosc 1999;13:280–282.
- Wojotowycz MM, Arata JA, Micklos TJ, et al: CT findings after uncomplicated percutaneous gastrostomy. Am J Roentgenol 1988;151:307–309.
Article / Publication Details
Published online: June 23, 2008
Issue release date: May – August
Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 0
eISSN: 1662-0631 (Online)
For additional information: https://www.karger.com/CRG
Open Access License / Drug Dosage / Disclaimer
Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
