title: Gastrojejunostomy Tube Bowel Perforations in Low-Weight Infants.
abstract: This is a case series in which 3 infants with gastrojejunostomy tube (GJT) insertion developed delayed perforation secondary to pressure necrosis. A review of all patients who underwent a GJT placement in 2013 was performed. Three of these patients developed surgically confirmed perforation secondary to pressure necrosis during this time period; no patients developed perforation at the time of GJT insertion. The indications for GJT insertion for all 3 patients were severe gastroesophageal reflux disease; 2 patients also had recurrent aspiration. The patients were between 9 weeks and 10 months of age at the time of GJT insertion. The site of perforation for all 3 cases occurred just distal to the ligament of Treitz between 48 and 72 hours following insertion. Given our 3 cases of perforation in patients weighing <10 kg, there may be a higher risk of perforation in low-weight patients.
authors.affiliation: Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Roxanne L
authors.initials: RL
authors.lastname: Massoumi
authors.affiliation: Department of Surgery, Our Lady's Children's Hospital, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Abdelhafeez H
authors.initials: AH
authors.lastname: Abdelhafeez
authors.affiliation: Division of Pediatric Surgery, Children's Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Christensen
authors.affiliation: Division of Pediatric Radiology, Children's Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Nghia J
authors.initials: NJ
authors.lastname: Vo
authors.affiliation: Division of Pediatric Gastroenterology, Children's Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Praveen S
authors.initials: PS
authors.lastname: Goday
authors.affiliation: Division of Pediatric Surgery, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Leack
authors.affiliation: Division of Pediatric Gastroenterology, Children's Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Duesing
authors.affiliation: Division of Pediatric Surgery, Children's Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, Wisconsin awagner@chw.org.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Wagner
mesh_terms: D004750:Enteral Nutrition; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight / Q000254:growth & development*; D007422:Intestines / Q000601:surgery; D007441:Intubation, Gastrointestinal; D008297:Male
keywords: GJ tube; enteral feeding complications; gastrojejunostomy tube; perforation