Jejunal perforation caused by a feeding jejunostomy tube: a case report.
BACKGROUND
Percutaneous endoscopic gastrostomy and feeding jejunostomy are used for providing long-term nutritional support to patients with neurological disorders. Various mechanical complications of these procedures are described.


METHODS
We report a case of a 17-year-old boy with cerebral injury who had a percutaneous endoscopic gastrostomy tube changed to a feeding jejunostomy tube. Twenty-four hours later he developed abdominal pain and became clinically septic. A contrast study through the feeding tube and a subsequent computed tomography scan did not reveal any intra-abdominal pathology. At laparotomy it was discovered that the tip of the feeding tube had perforated through the jejunal wall and was lying outside the lumen. This was successfully treated by re-inserting a feeding jejunostomy tube distally and closure of the perforation and previous FJ site


CONCLUSIONS
We suggest that the threshold for contrast studies and operative intervention should be low in neurologically impaired patients to avoid the delay in treatment of tube-related complications.
Stylianides
Nicholas A
NA
Department of Gastrointestinal Surgery, Lancashire Teaching Hospital NHS Foundation Trust, Preston Road, Chorley, Lancashire, UK. nickstylianides@hotmail.com
Date
Ravindra S
RS
Pursnani
Kishor G
KG
Ward
Jeremy B
JB