Percutaneous trans-stomal jejunostomy: a new technique

Aim We propose a new technique for feeding a malnourished patient with a "high" double-barrel jejunostomy (at about 60 cm from the Treitz Ligament). The procedure aims to restore an adequate nutritional state maintaining a correct diet for 24 h a day, without complications and without interfering with the normal activity of the nurses caring for the stoma. Method Using local anesthesia, we introduced a Reverdin needle through the efferent loop of jejunostomy and externalized it through the skin, medially from jejunostomy of about 10 cm. Using this guide, we inserted an enteral feeding tube with a blunt tip and then introduced it through the efferent loop to reach about 40 cm distantly into the bowel. Results The stoma output decreased from 3 to 1.5 L/day; kidney status was restored to normal function. Conclusion The main advantages are the minimal invasiveness of the implantation procedure, the possibility of nutrition during all 24 h, and the easy management by nurses.