Risk of abdominal septic complications after feeding jejunostomy placement in patients undergoing splenectomy for trauma.
Compared with total parenteral nutrition, enteral feeding via jejunostomy reduces septic complications in patients with severe trauma. However, violation of the bowel with insertion of a jejunostomy tube may increase the risk of intra-abdominal abscess (IAA), particularly if no simultaneous gastrointestinal tract injury exists. The records of 123 patients requiring splenectomy for trauma at a level I trauma center during a 6-year period (1986 to 1992) were reviewed to examine the incidence of IAA in patients with and without simultaneous jejunostomy placement in the presence and absence of gastrointestinal tract injuries. Thirty patients had jejunostomies placed (J), and 93 did not (NoJ). There were no significant differences between the groups in age, Abdominal Trauma Index, Injury Severity Score, or transfusion requirements. The incidence of IAA was not significantly different between the J and NoJ groups in the presence or absence of gastrointestinal tract injuries. Thus, jejunostomy placement does not increase the incidence of IAA after splenectomy regardless of the presence of a gastrointestinal tract injury.
Dent
D
D
Department of Surgery, University of Tennessee, Memphis 38163.
Kudsk
K A
KA
Minard
G
G
Fabian
T
T
Nguyen
T
T
Pritchard
E
E
Pate
L
L
Croce
M
M
D000005:Abdomen; D000328:Adult; D004064:Digestive System / Q000293:injuries; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology*; D007582:Jejunostomy / Q000009:adverse effects*; D008297:Male; D013156:Splenectomy; D014947:Wounds and Injuries / Q000628:therapy*