Small bowel perforation consecutive to feeding jejunostomy: A case report

Abstract

Introduction: Feeding jejunostomy is a rather safe procedure. Major complications are rare, but can be serious, nevertheless. Case Report: We report a case of a 57-year-old male, diagnosed with epidermoid carcinoma of the larynx. The patient received 3 cures of induction chemotherapy before being lost to follow-up. One year later, the patient presented with significant dysphagia and benefited from a feeding jejunostomy utilizing the Witzel technique. Postoperative course was marked by abdominal tenderness, and hemodynamic and respiratory impairment. Lab tests showed a continuous elevation of markers of infection. Computed tomography (CT) scan revealed an extradigestive distal end of the jejunostomy tube, associated with a voluminous pneumoperitoneum, predominant around the tube end, keeping with a small bowel perforation. The evolution was marked by respiratory fatigue, and hemodynamic instability. The patient, unfortunately died subsequently, despite maximal supportive measures. Conclusion: Computed tomography (CT) scan is a helpful tool for the diagnosis of feeding jejunostomy’s major complications besides physical examination and biology. Limiting the indications of this surgical procedure and being attentive to surgical details may help reduce the risk of complications.