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Very Rare Complication of Percutaneous Endoscopic Jejunostomy Feeding Tubes in Patients with Intestinal Dysmotility

by Masuod Yousefzada*, K. Boden, M. Gottwald, D. Merkel

Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, Germany

*Corresponding author: Masuod Yousefzada, Immanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, Germany

Received Date: 01 November 2023

Accepted Date: 06 November 2023

Published Date: 08 November 2023

Citation: Yousefzada M, Boden K, Gottwald M, Merkel D  (2023) Very Rare Complication of Percutaneous Endoscopic Jejunostomy Feeding Tubes in Patients with Intestinal Dysmotility. Ann Case Report 8: 1505. https://doi.org/10.29011/2574-7754.101505

Introduction

Percutaneous endoscopic jejunostomy feeding tubes are necessary as a long-term solution to ensure adequate enteral nutrition in patients with certain neurological, oncological, or geriatric diseases.

The complication rates for the PEG tube are between 8-30% and for the PEJ tube are between 2%-12%. Coiling, kinking, mispositioning, occlusion, or disruption of the jejunostomy tube have been reported very frequently, but knot formation in the feeding tube appears to be rare iii.

Interestingly, we observed this rare complication of PEJ in a 74-year-old patient with severe neurological disease and recurrent aspiration pneumonia.

Figure 1: Rare complication of PEJ in a 74-year-old patient.

The patient presented to us with PEJ dysfunction. Here we saw a knotted PEJ tube after performing a gastroscopy. The PEG and PEJ tubes were removed orally and a PEG/PEJ was inserted via the existing gastrostomy without any complications. The cause of the PEJ tube tangle is not clear.  However, various reasons for this have been speculated, for example, gastric motility disorder or initial mal-positioning of the Tube. In some literature, the reason for a tangled tube was described as a result of the tube being placed very low.

We suggest, that if a PEJ tube malfunctions occur, a knot in the tube should also be considered as a differential diagnosis.

References

  1. Cosentini, et al. (2001) 17 KEYMLING.
  2. Myers A, Thurston W, Ho CS (1997) Spontaneous knotting of a transgastric jejunostomy tube: case report. Can Assoc Radiol J. 48:22–24.
  3. Cappell MS, Scarpa PJ, Nadler S, Miller SH. (1992) Complications of nasoenteral tubes. Intragastric tube knotting and intragastric tube breakage. J Clin Gastroenterol. 14:144–147.

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