Jejunostomy tube failure: malnutrition caused by intraluminal antegrade jejunostomy tube migration.
Complications occurring with jejunostomy feeding tubes are common and sometimes life-threatening. We describe a case of peristalsis-induced intraluminal antegrade migration of a jejunostomy tube's distal end with concomitant retrograde movement of the small bowel over the tube, which was first discovered at autopsy. This ultimately resulted in the jejunostomy feedings entering the distal ileum, therefore bypassing most of the small intestine. Subsequent malnutrition was a contributing factor in the death of the patient, who had required tube feedings after suffering severe head trauma in a motor vehicle accident 29 months earlier. The only nutritional interventions attempted before death involved various attempts at controlling diarrhea. We discuss the incidence, cause, recognition, and prevention of this rarely reported complication of a "functioning" jejunostomy feeding tube.
Prahlow
J A
JA
Southwestern Institute of Forensic Sciences and the Department of Pathology, University of Texas Southwestern Medical School, Dallas, USA.
Barnard
J J
JJ
D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation; D004750:Enteral Nutrition; D017809:Fatal Outcome; D005548:Foreign-Body Migration; D006801:Humans; D007582:Jejunostomy; D008297:Male; D009104:Multiple Trauma / Q000534:rehabilitation; D009748:Nutrition Disorders / Q000209:etiology*; D009752:Nutritional Status