Direct Percutaneous Endoscopic Jejunostomy in a Patient with Brain Infarction Previously Treated by Total Gastrectomy

Abstract

We established a direct percutaneous endoscopic jejunostomy (PEJ) in a 75-year-old man with brain infarction. He had undergone total gastrectomy for gastric cancer.
This procedure has been conventionally performed in the pull or push method ; however, we have done it in the introducer method using an 11 French peel-away sheathed introducer. Postoperative adhesion between the jejunum and the abdominal wall facilitated this method. Temporary leakage of intestinal fluid occurred, but it ceased in six days.
PEJ is indicated in patients with previous gastric surgery in whom a percutaneous endoscopic gastrostomy is not easily placed.