Complications of surgical feeding jejunostomy in trauma patients.
OBJECTIVE
To determine the complication rate of feeding jejunostomy (FJ) performed as an adjunct to trauma celiotomy.


METHODS
Retrospective analysis of 222 patients from January of 1988 to May of 1998.


RESULTS
Thirty-seven total FJ-related complications occurred in 22 patients (10%). Major FJ-related complications occurred in nine patients (4%): two small bowel perforations, two small bowel volvuli with infarction, two intraperitoneal leaks, and three small bowel necroses. Patients suffering major FJ-related complications were similar to those without complications, except for the FJ type. Patients with major FJ-related complications were more likely to have had a Witzel tube jejunostomy than a needle catheter jejunostomy (p = 0.03). Three deaths were related to major FJ complications, for a FJ-related mortality rate of 1.4%.


CONCLUSIONS
FJ has a major complication rate of 4% in severely injured patients. Major complications occur more frequently with larger, Witzel-type tubes. Needle catheter jejunostomy appears to be a safer method of surgical jejunal access in trauma patients.
Holmes
J H
JH
Department of Surgery, Virginia Mason Medical Center, Seattle, Washington, USA.
Brundage
S I
SI
Yuen
P
P
Hall
R A
RA
Maier
R V
RV
Jurkovich
G J
GJ
D015998:Abbreviated Injury Scale; D000208:Acute Disease; D000328:Adult; D002423:Cause of Death; D016002:Discriminant Analysis; D004750:Enteral Nutrition / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007238:Infarction / Q000209:etiology; D015601:Injury Severity Score; D007415:Intestinal Obstruction / Q000209:etiology; D007416:Intestinal Perforation / Q000209:etiology; D007422:Intestines / Q000098:blood supply / Q000473:pathology; D007582:Jejunostomy / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000628:therapy*; D009336:Necrosis; D012189:Retrospective Studies; D016896:Treatment Outcome