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.
|Male, 25. Severe cerebral palsy with dysphagia and recurrent aspiration pneumonia||Large paraoesophageal hernia with proximal jejunum in thorax||Enteroscope 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 ascites||Enteroscope used. Deep loop of jejunum punctured with fluoroscopic guidance|
|Female, 65. Gastric linitis plastica with peritoneal metastases||Overweight patient with mobile jejunum||Enteroscope used. Jejunum punctured with fluoroscopic guidance|