Diagnostic and Therapeutic Endoscopy / 2009 / Article / Tab 2

Clinical Study

Direct Percutaneous Endoscopic Jejunostomy: High Completion Rates with Selective Use of a Long Drainage Access Needle

Table 2

Case summaries of three examples of DPEJ insertion where particular procedural difficulties were encountered, and where the drainage access needle was helpful in ensuring a successful outcome. No case developed any complication.

CaseProcedural challengeTechnique

Male, 25. Severe cerebral palsy with dysphagia and recurrent aspiration pneumoniaLarge paraoesophageal hernia with proximal jejunum in thoraxEnteroscope with overtube used. Jejunum punctured within thorax (via diaphragmatic hiatus from abdominal wall approach) with fluoroscopic guidance
Female, 53. Pancreatic cancer with partial duodenal obstruction and peritoneal metastases Large volume of omental malignancy and moderate amount of ascitesEnteroscope used. Deep loop of jejunum punctured with fluoroscopic guidance
Female, 65. Gastric linitis plastica with peritoneal metastasesOverweight patient with mobile jejunumEnteroscope used. Jejunum punctured with fluoroscopic guidance

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