Jejunostomisch

Jejunostomisch refers to anything pertaining to a jejunostomy, a surgically created opening (stoma) into the jejunum, which is the middle portion of the small intestine. Through this outlet, tubes or access devices can be placed to deliver nourishment or drain contents, bypassing the stomach or proximal intestine as needed.

Jejunostomy is used for long-term enteral nutrition in patients who cannot take food orally or when gastric feeding is not advisable due to risk of aspiration, obstruction, or severe reflux. It may also be employed to drain secretions in certain intestinal disorders or after specific abdominal surgeries. Several approaches exist, including surgical jejunostomy (open or laparoscopic), percutaneous endoscopic jejunostomy (PEJ), and radiologically guided or radio-opaque jejunostomy techniques. In PEJ, a feeding tube is placed into the jejunum using endoscopic guidance, sometimes via a transgastric or direct jejunal route, while radiologic methods rely on imaging to position and fix the catheter.

Typical devices include jejunostomy tubes or buttons designed for enteral feeding, with daily flushes and gradual advancement of feeding rates as tolerated. Ongoing care focuses on stoma hygiene, preventing tube occlusion, and monitoring for signs of infection or leakage. Patients require regular assessment of nutritional status and tube function, with adjustments to feeding regimens as needed.

Complications can include infection, skin irritation, tube dislodgement or occlusion, leakage leading to peritonitis, fistula formation, and rarely obstruction or stenosis of the jejostomy tract. Jejunostomisch procedures are weighed against alternatives such as nasojejunal tubes or gastric feeding with jejunal extension, depending on patient needs and risks.