Feeding jejunostomy: a small bowel stress test?
A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, including five cases of fatal small bowel necrosis. There was a significant increase in risk factors for decreased mesenteric blood flow in those patients with small bowel necrosis compared with those without this complication. In addition, the other 17 patients with abdominal distention (a manifestation of tube feeding intolerance) had a significantly increased number of risk factors for decreased mesenteric blood flow. Documented low-flow states should prompt discontinuation of tube feedings even in the patient without gastrointestinal symptoms and signs. Distention is a nonspecific but ominous finding and should prompt discontinuation of tube feedings permanently unless a reversible cause for distention is determined.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007238:Infarction / Q000209:etiology; D007421:Intestine, Small / Q000098:blood supply; D007511:Ischemia / Q000209:etiology; D007582:Jejunostomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009336:Necrosis