Jejunostomy. A rarely indicated procedure
M. B. Adams, G. R. Seabrook, E. A. Quebbeman and R. E. Condon
Jejunostomy is an alternative for alimentation in patients who cannot be
fed orally. Seventy-three patients from the Medical College of Wisconsin
Hospitals, Milwaukee, who underwent jejunostomy for gastrointestinal tract
obstruction or dysfunction (28 patients), carcinoma (23 patients),
neurologic disorders (13 patients), and other indications (nine patients)
by the Stamm (46 patients), Witzel (17 patients), and Maydl (nine patients)
techniques were studied. Forty-four patients survived and were discharged,
while 29 died in the hospital. Fifty-three complications were documented
among 34 patients. The jejunostomy was actually used for feeding in only 48
patients, and only 18 were discharged while receiving maintenance
enterostomy feedings. Seven patients died as a direct result of
complications of the jejunostomy. Jejunostomy is not an innocuous
procedure; it carries a substantial risk of death and complications.
Jejunostomy should be performed for alimentation only in patients with
clear indications and a high potential for long-term use.
