SMALL-BOWEL NECROSIS IN ASSOCIATION WITH JEJUNOSTOMY TUBE FEEDINGS

Nutritional support is thought to be an important adjunct for minimizi ng perioperative morbidity. For a variety of reasons, it is now felt t hat nutrition delivered by the enteral route is preferred over that gi ven parenterally. Although delivery of nutrients into the small intest ine, either vira a nasoduodenal tube or a surgically placed jejunostom y, is effectively tolerated by most patients, morbid complications are being described with increased frequency. Herein, we describe two pat ients who underwent major intra-abdominal surgery, one for a malignanc y, the other for trauma management. Immediate postoperative feedings w ere instituted through a surgically placed jejunostomy tube. Several d ays later, each patient underwent emergency reoperation for clinical f indings of an intra-abdominal catastrophe. In both patients, small int estinal infarction in juxtaposition to the site of the tube feedings w as found, This experience suggests that the enteral feedings were caus ally related to this morbid complication, which proved fatal in one pa tient.