JEJUNOSTOMY TUBE FAILURE - MALNUTRITION CAUSED BY INTRALUMINAL ANTEGRADE JEJUNOSTOMY TUBE MIGRATION

Complications occurring with jejunostomy feeding tubes are common and sometimes life-threatening. We describe a case of peristalsis-induced intraluminal antegrade migration of a jejunostomy tube's distal end wi th concomitant retrograde movement of the small bowel over the tube, w hich was first discovered at autopsy. This ultimately resulted in the jejunostomy feedings entering the distal ileum, therefore bypassing mo st of the small intestine. Subsequent malnutrition was a contributing factor in the death of the patient, who had required tube feedings aft er suffering severe head trauma in a motor vehicle accident 29 months earlier. The only nutritional interventions attempted before death inv olved various attempts at controlling diarrhea. We discuss the inciden ce, cause, recognition, and prevention of this rarely reported complic ation of a ''functioning'' jejunostomy feeding tube. (C) 1998 by the A merican Congress of Rehabilitation Medicine and the American Academy o f Physical Medicine and Rehabilitation.