nasojejunal

Nasojejunal refers to a nasally inserted tube that extends into the jejunum, the middle section of the small intestine. A nasojejunal tube (NJT) is designed for enteral feeding or decompression when gastric feeding is not appropriate or when reducing the risk of aspiration is important.

Placement and confirmation typically involve inserting the tube through the nose and guiding it from the esophagus into the stomach and then into the jejunum. In many cases placement is verified with radiographic imaging, though some bedside methods use aspirate analysis or other markers. A clinician may use endoscopic, fluoroscopic, or electromagnetic guidance to facilitate jejunal positioning. The tube is usually made of polyurethane or silicone and commonly measures 8–12 French, with a distal tip intended to lie in the jejunum.

Indications include enteral nutrition for patients at high risk of aspiration from gastric feeding, those with gastroparesis or gastric outlet obstruction, pancreatitis requiring jejunal feeding, post-surgical enteral support, or other conditions where bypassing the stomach is advantageous.

Maintenance involves confirming tube position before feeding, regular flushing to prevent occlusion, and monitoring for signs of intolerance or misplacement. The tube requires appropriate securing and care of nasal passages to minimize discomfort and nasal irritation.

Complications can include nasal or sinus irritation, tube clogging or dislodgement, misplacement into the stomach or airway with potential aspiration, esophageal injury, perforation, or rarely pneumothorax. Cautions include avoiding nasal tubes in patients with certain facial or basilar skull injuries, severe nasal obstruction, or anatomical issues that impede safe placement.