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Clinically Significant Pneumatosis Intestinalis with Postoperative Enteral Feedings by Needle Catheter Jejunostomy: An Unusual Complication
Author(s) -
Smith C. Daniel,
Sarr Michael G.
Publication year - 1991
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607191015003328
Subject(s) - jejunostomy , medicine , enteral administration , pneumatosis intestinalis , complication , parenteral nutrition , catheter , surgery , intensive care medicine
We evaluated the incidence of clinically significant pneumatosis intestinalis and intestinal necrosis with the use of needle catheter jejunostomy in 217 consecutive patients who had undergone complicated abdominal operations or selected bariatric procedures. The needle catheter jejunostomy was used to deliver immediate postoperative nutrition, maintenance, and replacement fluids, and selected medications. In this group, no serious complications requiring surgical intervention were related to the use of needle catheter jejunostomies. Clinically significant pneumatosis intestinalis was encountered in two of 217 patients (1%). With the needle catheter jejunostomy in place, both patients improved rapidly when enteral feedings were discontinued and parenteral antibiotics were administered. None of the 217 patients developed ischemic intestinal necrosis. We conclude that 1) clinically significant pneumatosis is a rare complication of enteric feeding via needle catheter jejunostomy when the intrajejunal feeding is begun with a diluted, hypoosmolar solution with stepwise increases in osmolality, and 2) patients who do develop clinically significant pneumatosis (n=2) seem to respond rapidly to a temporary stoppage of enteral feedings and administration of parenteral antibiotics. ( Journal of Parenteral and Enteral Nutrition 15 :328–331, 1991)