Percutaneous jejunostomy

What is a percutaneous image-guided jejunostomy?

During a percutaneous image-guided jejunostomy, your interventional radiologist places a tube directly through the abdominal wall into a part of the small intestine, the jejunum. This tube allows for feedings. A jejunostomy is a good alternative for patients who cannot absorb nutrients through their stomachs, such as patients facing nausea or vomiting, or patients who have had stomach surgery or who have a tumor in their stomach or jejunum. 

What to expect?

A jejunostomy is generally placed under a local anesthetic, combined with a sedative. You may have to spend one night at the hospital for this procedure. Please do not eat solid foods 8 hours before the procedure, and only drink clear liquids. Please do not drink anything 4 hours before the procedure,

Before your procedure, your gastroenterologist will insert a tube through your nose into your jejunum (small intestine. This tube can bring liquids into the small intestine during the procedure. We will administer an IV at the ward, through which we can give you a drug that will temporarily prevent the muscles in your intestines from moving. Then we will add air and liquid into your small intestine through the tube. This allows us to better see the area through imaging.

The procedure will take place at the radiology department. You will be lying down on your back with an x-ray tube. This table is designed for use with image-guided procedures. Your interventional radiologist will make an ultrasound to find the best placement. The jejunum (small intestine) will be punctured under the guidance of x-ray or ultrasound imaging. The needle will be attached to the skin using anchors, which allows for better access to the jejunum when placing the tube. Through a small incision and a dilation of the puncture, the jejunostomy tube will be placed, This tube will remain in place using a balloon or bumper.

The tube cannot be used for 6 hours after the procedure. After this time, or the next day, we will administer a test feeding using some water. If no problems occur, you can start your regular feeds.

What are the potential risks and side effects?

Air and gas in the abdomen is a common result of the procedure, as is bruising. These usually do not cause any problems. Complications occur in approximately 10% of patients. Smaller complications include incorrect placement of the tube, granulation tissue (red and painful skin during the healing process), and light bleeding or infection in the area. Major complications include perforation of the small intestine or an infection in the lungs or airways caused by food or other substances entering the airways.