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空肠造口喂养管的自发性肠道移位:一种罕见的并发症。

Spontaneous Enteral Migration of a Feeding Jejunostomy Tube: An Unusual Complication.

作者信息

Kundal Ashikesh, Singh Sudhir, Sharma Jyoti, S Dhivakar, Karn Summi

机构信息

Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

出版信息

Cureus. 2023 Feb 11;15(2):e34861. doi: 10.7759/cureus.34861. eCollection 2023 Feb.

Abstract

Established consensus suggests that enteral nutrition is more beneficial in patients with a functioning gut than parenteral nutrition. It helps in early physical rehabilitation from a disease or surgical stress and is associated with fewer complications compared to parenteral nutrition. Jejunal feeding is one of the routine modes of enteral nutrition in patients with gastric dysfunction, either due to surgery or critical illness. Various complications have been reported when using feeding tubes, grouped as mechanical, infectious, gastrointestinal, and metabolic. Here, we report an unusual case of a 47-year male with a history of prepyloric perforation repair leak who presented to us on postoperative day 14 with an enterocutaneous fistula and a feeding jejunostomy tube in situ. He was evaluated and managed conservatively and discharged on enteral feeds, both orally and via a jejunostomy tube. One month after discharge, he presented with features of intestinal obstruction with a missing jejunostomy tube. Radiological investigations suggested enteral migration of the jejunostomy tube, which was managed non-operatively, and the patient was discharged on day three post-admission after per rectal expulsion of the tube.

摘要

已达成的共识表明,对于肠道功能正常的患者,肠内营养比肠外营养更有益。它有助于患者从疾病或手术应激中早日身体康复,且与肠外营养相比,并发症更少。空肠喂养是胃功能障碍患者(因手术或危重病导致)肠内营养的常规方式之一。使用喂养管时已报告了各种并发症,分为机械性、感染性、胃肠道和代谢性并发症。在此,我们报告一例不寻常病例,一名47岁男性,有幽门前穿孔修补漏病史,术后第14天因肠皮肤瘘和空肠造口喂养管在位前来就诊。对其进行评估并采取保守治疗,通过口服和空肠造口管给予肠内营养后出院。出院一个月后,他因空肠造口管缺失出现肠梗阻症状。影像学检查提示空肠造口管发生肠内移位,对此进行了非手术处理,患者在入院后第三天经直肠排出该管后出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7760/10010317/3d7ef8914129/cureus-0015-00000034861-i01.jpg

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