title: Replacement of a string jejunostomy if the suture is lost: first time a technique with no need to cut.
abstract: OBJECTIVE
  The aim of the study was to present the first case of replacement of a string jejunostomy with an enteroscopic percutaneous technique after the string was lost. The replaceable string jejunostomy is a well-established method for the enteral feeding in patients where the swallowing process is impaired and gastroesophageal reflux impedes the option of a gastrostomy. In the frequent case of obstruction, rupture or malfunction of the jejunostomy, it is easily replaced in an outpatient setting without anesthesia, with the help of the string that holds the tip of the feeding tube in place. In our case the string was lost.
  
  
  METHODS
  The jejunostomy was replaced with a fully percutaneous technique with the help of a pediatric cystoscope.
  
  
  RESULTS
  This technique is well practicable and obviated the need for a laparotomy in a polymorbid patient.
  
  
  CONCLUSIONS
  The technique seems promising, but we report an anecdotal case description. Further experience is needed to investigate its safety.
authors.affiliation: Department of Pediatric Surgery, University Childrens Hospital Basel, Basel, Switzerland. gaston.debernardis@ukbb.ch
authors.forename: Gaston
authors.initials: G
authors.lastname: De Bernardis
authors.forename: Johannes
authors.initials: J
authors.lastname: Mayr
mesh_terms: D002648:Child; D003680:Deglutition Disorders / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012086:Reoperation; D013537:Sutures