FAILURE OF A FEEDING JEJUNOSTOMY

A healthy 16-year-old female pedestrian was hit by a motor vehicle. Sh e sustained multiple injuries including severe head injury. She was ad mitted to hospital unconscious. There was no recovery of neurological function. After a short period of time, a jejunostomy was performed fo r feeding purposes. The major clinical problem continued to be a feedi ng difficulty, with profuse diarrhoea occurring. At no stage was it po ssible to adequately nourish her. Hyperperistalsis was noted whilst in hospital. She died just over three months after admission. Autopsy re vealed an emaciated body weighing only 25kg. An upperjejunostomy was s till present containing a No. 20 French catheter. The bulb had threade d down the small bowel so that it was situated 25cm proximal to the il eocaecal valve. The small bowel was empty. The cause of death was give n as malnutrition due to failure of function of a feeding jejunostomy due to small bowel hyperperistalsis in an individual with diffuse brai n trauma. This complication of feeding jejunostomy causing death from malnutrition has not previously been described in the English literatu re.