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Semin intervent Radiol 2004; 21(3): 199-204
DOI: 10.1055/s-2004-860878
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Percutaneous Jejunostomy

Hans van Overhagen1 , 2 , Jaap Schipper2
  • 1Interventional Radiologist, Leyenburg Hospital, Den Haag, The Netherlands
  • 2Department of Radiology, Leyenburg Hospital, Den Haag, The Netherlands
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Publication History

Publication Date:
16 December 2004 (online)

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ABSTRACT

Direct percutaneous jejunostomy is considered in patients where percutaneous gastrostomy is not feasible (stomach removed or inaccessible). Percutaneous jejunostomy is more difficult than gastrostomy techniques. Direct jejunostomy is performed under fluoroscopic guidance, using a nasojejunal tube to distend the jejunum. The jejunal loop is punctured using a Cope suture anchor, under ultrasound guidance. Water-soluble contrast material is injected through the needle to document intralumenal position, and an anchor is inserted. With the guide wire in place, the track is dilated and a 10-F pigtail catheter inserted into the proximal jejunum. Fluoroscopy can also be used to aid puncture using dilute contrast material, if used via the nasogastric tube. Antiperistaltic agents can also be used to aid jejunal puncture. The cumulative procedure-related mortality from the three reported series in the literature is 2.4%, with minor complications occurring in 10 to 11%. Although jejunostomy is not performed frequently, this is a feasible procedure for interventional radiology.

KEYWORDS

Percutaneous jejunostomy - jejunal obstruction

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Hans van OverhagenM.D. 

Dept. of Radiology, Leyenburg Hospital

Leyweg 275, 2545 CH Den Haag, The Netherlands

Email: Hansen@vanoverhagen.demon.nl

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