Percutaneous Endoscopic Gastrostomy with Jejunal Extension for an Encapsulating Peritoneal Sclerosis Refractory to Surgical Enterolysis

Banshodani, Masataka; Kawanishi, Hideki; Moriishi, Misaki; Shintaku, Sadanori; Hashimoto, Shinji; Tsuchiya, Shinichiro

doi:10.3747/pdi.2015.00260

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…We also experienced patients where the symptoms of intestinal obstruction were not ameliorated by narrowing of the anastomotic site and kinking of the small intestine of the oral side. In that case, percutaneous endoscopic gastrostomy and/or jejunal extension was carried out and managed with TPN at home (18). Based on our experiences, we recognize that enterolysis in EPS differs depending on individual patient characteristics, including various factors such as grade of peritoneal deterioration, calcification, and adhesion range.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Encapsulating Peritoneal Sclerosis: 24 Years’ Experience

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Encapsulating Peritoneal Sclerosis: 24 Years’ Experience

et al. 2019

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“…Although the surgical technique is simple, it is necessary to perform careful procedures involving only the division of peritoneal adhesions by repeated lysis of fibrin membranes with sharp instruments such as Metzenbaum scissors and surgical scalpel, especially for severe adhesions with a retracted mesentery and calcification. However, EPS is occasionally refractory to surgical enterolysis due to intraperitoneal complications (3).…”

Section: Discussionmentioning

confidence: 99%

“…E ncapsulating peritoneal sclerosis (EPS) with symptomatic bowel obstruction, a life-threatening complication in PD patients (1), is remedied by surgical treatment as a final option (2). However, in some cases, EPS is refractory to surgical treatment (3).…”

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Effective Remedy for Encapsulating Peritoneal Sclerosis with Ureteroileal Fistula

et al. 2017

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Encapsulating peritoneal sclerosis (EPS), treated with surgical enterolysis as a final option, may become refractory to surgical intervention due to intraperitoneal complications. We report the case of a 59-year-old man presenting with EPS who underwent enterolysis at the age of 50, following 15 years of peritoneal dialysis (PD) and peritonitis. During the patient's first surgery, complete surgical enterolysis could not be performed due to severe intestinal adhesions with a deteriorated/calcified small bowel. Six months after the surgery, the obstructive bowel symptoms occurred several times a year. Nine years later, the patient suffered cystitis-like symptoms and fecal discharge from the urinary meatus. The patient was subsequently diagnosed with EPS recurrence with ureteroileal fistula between the right ureter and ileum. During the second surgical intervention, we conducted a divided jejunostomy, as surgical enterolysis and fistulectomy were unachievable due to severe ileal adhesion with calcified capsule and inflammation. Thereafter, symptoms reduced dramatically and oral intake became possible. Three years following surgery, the patient's condition is improved, with no evidence of EPS recurrence or cystitis-like symptoms. Although EPS with ureteroileal fistula is extremely rare, we propose that jejunostomy may be an effective treatment option for patients with EPS refractory to surgical enterolysis or intestinal bypass due to intraperitoneal complications.

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“…This approach would offer the benefit of postpyloric enteral feeding while simultaneously being able to decompress the stomach. Reports of a PEG with jejunal extension (PEG-JET) have even been reported as palliative enteral decompression while providing parenteral nutrition by Banshonandi et al 32 Patients with significant gastroesophageal reflux, history of reflux of gastric tube feed content, repeated aspiration events, gastroparesis, and malignant gastric outlet obstruction not amenable to resection or stenting are potential beneficiaries of this approach. Unfortunately, this approach has a limited clinical role as it is fraught with a high reported failure rate of 27 to 84% of the feeding catheter as it dislodges frequently back into the stomach.…”

Section: Percutaneous Endoscopic Gastrojejunostomymentioning

confidence: 99%

Endoscopic Feeding Access

McCormack

Tariq

2018

Dig Dis Interv

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The need for enteral access for nutritional support has become increasingly important. It is estimated up to a third of hospitalized patients will suffer from malnourishment. There is evidence that enteral is preferable over parenteral nutrition for improved outcomes. Various approaches for enteral access exist today including blind placement of enteral catheters, radiographically, and surgically placed catheters. However, the endoscopic approach for enteral access is a well-established, reliable, safe, and quick method of obtaining enteral access. In this review article, we will cover the various endoscopic approaches for enteral access. We believe there is no single best approach for enteral access and that it should be tailored to the individual patient. This article will cover both temporary options such as nasoenteric catheters and more permanent options such as percutaneous endoscopic stomas (gastrostomy, gastrojejunostomy, direct jejunostomy) and describe their techniques, indications, contraindications, and pitfalls. Additionally, with the rise of weight loss surgery, we will cover how to manage the patient with altered gastrointestinal anatomy. Lastly, we will also review difficult post procedure scenarios associated with all of these endoscopic methods for enteral access and how to either prevent or properly manage them.

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Percutaneous Endoscopic Gastrostomy with Jejunal Extension for an Encapsulating Peritoneal Sclerosis Refractory to Surgical Enterolysis

Cited by 6 publications

References 10 publications

Surgical Treatment for Encapsulating Peritoneal Sclerosis: 24 Years’ Experience

Surgical Treatment for Encapsulating Peritoneal Sclerosis: 24 Years’ Experience

Effective Remedy for Encapsulating Peritoneal Sclerosis with Ureteroileal Fistula

Endoscopic Feeding Access

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