Satoh Takayuki, Sawada Kazue, Satoh Miyuki, Yohko Kikuchi, Yamada Masataka, Zaitsu Masaaki, Osada Tadahiro, Sawaya Reiji, Nata Toshie, Ueno Nobuhiro, Moriichi Kentaro, Ikuta Katsuya, Mizukami Yusuke, Watari Jiro, Fujiya Mikihiro, Kohgo Yutaka
Shibetsu City Hospital, Shibetsu, Japan.
BMJ Case Rep. 2011 Mar 3;2011:bcr0720103169. doi: 10.1136/bcr.07.2010.3169.
Percutaneous endoscopic jejunostomy (PEJ) has been developed and is considered to be a better method than percutaneous endoscopic gastrostomy for preventing the occurrence of aspiration pneumonia. However, the incidence of other complications associated with this procedure is less clear. We herein report a rare case with a small intestinal intussusception due to a PEJ placement. In this case, a radiologic examination with gastrografin was useful to detect the typical findings of a small intestinal intussusception, a beak-like filling defect, and identify the location of the lesion. An endoscopic examination that was carefully performed with a thin scope was effective to observe the ischaemic change of the small intestine and immediately determine the indication for surgical treatment. This case highlights the necessity to carefully manage patients with a PEJ placement, considering the risk of small intestinal intussusceptions when the patient complains of symptoms that are suspicious for an intestinal obstruction.
经皮内镜下空肠造口术（PEJ）已被开发出来，并且被认为是一种比经皮内镜下胃造口术更好的预防吸入性肺炎发生的方法。然而，与该手术相关的其他并发症的发生率尚不清楚。我们在此报告一例因PEJ置入导致小肠套叠的罕见病例。在该病例中，使用泛影葡胺进行的放射学检查有助于检测小肠套叠的典型表现，即鸟嘴样充盈缺损，并确定病变位置。使用细内镜仔细进行的内镜检查对于观察小肠的缺血变化并立即确定手术治疗指征是有效的。该病例强调了在对接受PEJ置入的患者进行仔细管理时的必要性，当患者出现疑似肠梗阻的症状时，要考虑到小肠套叠的风险。
