Internal Hernia with Small Bowel Volvulus in a Patient with Altered Gut Motility: A Complication of Direct Percutaneous Endoscopic Jejunostomy

Potter, Mark B.; Bowers, Steven B.; Pruitt, Alejandro

doi:10.1007/s10620-007-9813-5

Cited by 8 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Following laparoscopic feeding jejunostomy some authors describe jejunal volvulus as a complication requiring a re-laparoscopy or laparotomy [19–21]. To prevent jejunal torsion and volvulus, the authors placed two additional intra-abdominal stitches 4 cm and 8 cm in the caudal direction starting from the jejunostomy ostium.…”

Section: Discussionmentioning

confidence: 99%

Totally laparoscopic feeding jejunostomy - a technique modification.

Bobowicz¹,

Makarewicz²,

Polec³

et al. 2011

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

In oncological patients with upper gastrointestinal tract tumours, dysphagia and cachexy necessitate gastrostomy or jejunostomy as the only options of enteral access for long-term feeding. In this article the authors describe a modified technique of laparoscopic feeding jejunostomy applied during the staging laparoscopy. A 48-year-old male patient with gastroesophageal junction tumour and a 68-year-old male patient with oesophageal tumour were operated on using the described technique. Exploratory laparoscopy was performed. Then the feeding jejunostomy was made using a Cystofix® TUR catheter. The jejunum was fixed to the abdominal wall with four 2.0 Novafil™ transabdominal stitches. Two additional sutures were placed caudally about 4 cm and 8 cm from the jejunostomy, aiming at prevention of jejunal torsion. Total operating time was 45 min. There was no blood loss. There were no intraoperative complications. The only adverse event was one jejunostomy wound infection that responded well to oral antibiotics. There were no mortalities. The described technique has most of the benefits of laparoscopic feeding jejunostomy with some steps added from the open operation making the procedure easier to perform as part of a staging operation with a relatively short additional operating time. The proposed transabdominal stitches make the technique easier to apply. Two additional ‘anti-torsion sutures’ prevent postoperative volvulus. Use of the Cystofix catheter allows easy introduction of the catheter into the peritoneal cavity and the jejunal lumen, providing a good seal at the same time. Further studies on larger groups of patients are required to assess long-term outcomes of the proposed modified technique.

show abstract

Section: Discussionmentioning

confidence: 99%

Totally laparoscopic feeding jejunostomy - a technique modification.

Bobowicz¹,

Makarewicz²,

Polec³

et al. 2011

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

show abstract

“…(Fig. 2c) The distal arm of the loop was secured to the abdominal wall with a running autoadjustable suture for 3-4 cm to prevent intestinal volvulus [3][4][5]. (Fig.…”

Section: Methodsmentioning

confidence: 99%

Autoadjustable Sutures and Modified Seldinger Technique Applied to Laparoscopic Jejunostomy

et al. 2014

View full text Add to dashboard Cite

This is a simple technique to be applied to those patients requiring an alternative feeding method. This technique has been successfully applied to 25 patients suffering from esophageal carcinoma. The procedure involves laparoscopic approach, suture of the selected intestinal loop to the abdominal wall and jejunostomy using Seldinger technique and autoadjustable sutures. No morbidity or mortality was reported.

show abstract

“…Alternative approaches to the use of a PEGJ tube are direct J tube placement via deep enteroscopy or combined laparoscopy/enteroscopy. Although this prevents the problem of displacement and reduces the risk of blockage (as a 12 to 15-French device can be inserted), the procedure is more invasive and associated with volvulus and internal herniation 4…”

mentioning

confidence: 99%