Jejeunal Variceal Hemorrhage: An Unusual Complication of Needle Catheter Jejeunostomy

Abstract

Needle catheter jejeunostomy is a useful method for providing fluid and nutritional support in selected patients after laparotomy. The technique is widely used, and complications are infrequent. We report herein a new complication of this procedure. A cirrhotic patient with portal hypertension underwent needle catheter jejeunostomy subsequent to esophageal transection for esophageal hemorrhage. The catheter functioned satisfactorily in the postoperative period and was removed before discharge. Approximately 1 yr later, gastrointestinal hemorrhage recurred which was localized to the site of the previous needle catheter jejeunostomy. Portasystemic collaterals between the small bowel and the abdominal wall at the jejeunostomy were the source of bleeding. Take-down of the jejeunostomy site and resection of the involved bowel successfully controlled hemorrhage. Needle catheter jejeunostomy may be contraindicated in patients with portal hypertension. (Journal of Parenteral and Enteral Nutrition 7:489-491, 1983)