The needle catheter feeding jejunostomy is being increasingly utilized for postoperative nutritional support. We report a case of catheter dislodgement with intraperitoneal infusion of an elemental diet with subsequent peritonitis and death. A review of the literature reveals this complication to occur in 1.5% of patients, even when the serosa of the small bowel has been attached to the anterior abdominal wall. Recommendations are made regarding the prevention and management of such complications. (Journal of Parenteral and Enteral Nutrition9:758-759, 1985)
Get full access to this article
View all access options for this article.
References
1.
Hill GL, Pickford I., Young GA, et al: Malnutrition in surgical patients: an unrecognized problem. Lancet1:689-692, 1977
2.
Mullen JL, Gertner MH, Buzby GP, et al: Implications of malnutrition in the surgical patient. Arch Surg114:121-125, 1979
3.
Delaney HM: An improved technqiue for needle catheter jejunostomy. Arch Surg115:1235-1237, 1980
4.
Delaney HM, Carnevale NJ, Garvey JW: Jejunostomy by a needle catheter technique. Surgery73:786-790, 1973
5.
Delaney HM, Carnevale NJ, Garvey JW, et al: Postoperative nutritional support using needle catheter feeding jejunostomy. Ann Surg186:165-170, 1977
6.
Page CP, Carlton PK, Andrassy RJ, et al: Safe, cost-effective postoperative nutrition: Defined formula diet via needle catheter jejunostomy. Am J Surg138:939-945, 1979
7.
Page CP, Ryan JA, Haff RC: Continual catheter administration of an elemental diet. Surg Gynecol Obstet142:184-188, 1976
8.
Yeung CK, Young GA, Hackett AF, et al: Fine needle catheter jejunostomy-an assessment of a new method of nutritional support after major gastrointestinal surgery. Br J Surg66:727-732, 1979
Schattenkerk ME, Obertop H., Bruining HA, et al: Needle catheter jejunostomy (NCJ) for early postoperative feeding: experience in 210 patients . Neth J Surg35:163-166, 1983
11.
Hoover HC, Ryan JA, Anderson EJ, et al: Nutritional benefits of immediate postoperative jejunal feeding . Am J Surg139:153-159, 1980
12.
Mullen JL, Buzby GP, Mathews DC, et al: Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support. Ann Surg195:604-613, 1980
13.
Fairfull-Smith RJ, Abunassar R., Freeman JB, et al: Rational use of elemental and nonelemental diets in hospitalized patients. Ann Surg192:600-603, 1980
14.
Freeman JB, Fairfull-Smith RJ: Current concepts in enteral feeding. Adv Surg16:75-112, 1983
15.
MacDonald HA : Intrajejunal drip in gastric surgery. Lancet2:1007, 1954
16.
Feldtman RW , Archie JP: A three year experience with needle catheter jejunostomy in a community hospital. Surg Gynecol Obstet159:23-26, 1984
17.
Bruining HA , Schattenkerk ME, Obertop H., et al: Acute abdominal pain due to early postoperative elemental feeding by needle jejunostomy. Surg Gynecol Obstet157:40-42, 1983
18.
Cogbill TH, Wolfson RH, Moore EE, et al: Massive pneumatosis intestinalis and subcutaneous emphysema: complication of needle catheter jejunostomy. JPEN7:171-175, 1983
