Ja. Prahlow et Jj. Barnard, JEJUNOSTOMY TUBE FAILURE - MALNUTRITION CAUSED BY INTRALUMINAL ANTEGRADE JEJUNOSTOMY TUBE MIGRATION, Archives of physical medicine and rehabilitation, 79(4), 1998, pp. 453-455
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.