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Erschienen in: Abdominal Radiology 8/2019

07.05.2019 | Interventional Radiology

The occlusion balloon reduction technique for de novo placement and salvage of malpositioned enteric tubes

verfasst von: Jeffrey Forris Beecham Chick, Neil Jairath, Jacob J. Bundy, Arjun Adapa, James J. Shields, Anthony N. Hage, Ravi N. Srinivasa

Erschienen in: Abdominal Radiology | Ausgabe 8/2019

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Abstract

Purpose

Nasoenteric, gastrojejunostomy, and jejunostomy tubes are methods of enteral nutrition in patients with functioning gastrointestinal tracts who cannot maintain adequate oral intake. Current placements; however, may be complicated by redundant wire and catheter loops within the stomach preventing operators from optimal feeding tube placement and predisposing patients to feeding tube prolapse. This report describes the occlusion balloon reduction technique for salvage of malpositioned tubes and placement of new enteric tubes in the setting of redundant loops.

Materials and Methods

Five patients underwent the occlusion balloon reduction technique for jejunostomy (n = 3), gastrojejunostomy (n = 1), or nasojejunal tube placement (n = 1). All patients (n = 5) had redundant wires coiled within the stomach. In all patients (n = 5), a 9-French × 32 mm × 120 cm Coda balloon was inserted over the wire and passed into the small bowel. The balloon was inflated after which reduction of redundancy in the upper gastrointestinal tract was performed. Feeding tubes were then placed with tips in the distal jejunum. Technical success of the occlusion balloon reduction technique, successful placement of enteric tube, complications, and follow-up were recorded.

Results

The occlusion balloon reduction was technically successful in all patients (n = 5). Feeding tube placement was successful in all patients (n = 5). No minor or major complication occurred. Mean follow-up was 56 days.

Conclusion

The occlusion balloon reduction technique provides a method for reduction of redundant wire and catheter loops within the stomach during enteric tube placement or repositioning.
Literatur
1.
Zurück zum Zitat Russell M, Stieber M, Brantley S, Freeman AM, Lefton J, Malone AM, Roberts S, Skates J, Young LS. American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and American Dietetic Association (ADA): standards of practice and standards of professional performance for registered dietitians (generalist, specialty, and advanced) in nutrition support. Nutr Clin Pract. 2007;22:558–586.CrossRefPubMed Russell M, Stieber M, Brantley S, Freeman AM, Lefton J, Malone AM, Roberts S, Skates J, Young LS. American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and American Dietetic Association (ADA): standards of practice and standards of professional performance for registered dietitians (generalist, specialty, and advanced) in nutrition support. Nutr Clin Pract. 2007;22:558–586.CrossRefPubMed
2.
Zurück zum Zitat Lochs H, Dejong C, Hammarqvist F, Hebuterne X, Leon-Sanz M, Schütz T, van Gemert W, van Gossum A, Valentini L, Lübke H, et al. ESPEN Guidelines on Enteral Nutrition: Gastroenterology. Clin Nutr. 2006;25:260–274.CrossRefPubMed Lochs H, Dejong C, Hammarqvist F, Hebuterne X, Leon-Sanz M, Schütz T, van Gemert W, van Gossum A, Valentini L, Lübke H, et al. ESPEN Guidelines on Enteral Nutrition: Gastroenterology. Clin Nutr. 2006;25:260–274.CrossRefPubMed
4.
Zurück zum Zitat Srinivasa RN, Chick JFB, Hage AN, Shields JJ, Saad WE, Majdalany BS, et al. Transnasal Snare Technique for Retrograde Primary Jejunostomy Placement After Surgical Gastrojejunostomy. Cardiovascular and Interventional Radiology. 2017; 40(12):1940–4.CrossRefPubMed Srinivasa RN, Chick JFB, Hage AN, Shields JJ, Saad WE, Majdalany BS, et al. Transnasal Snare Technique for Retrograde Primary Jejunostomy Placement After Surgical Gastrojejunostomy. Cardiovascular and Interventional Radiology. 2017; 40(12):1940–4.CrossRefPubMed
5.
Zurück zum Zitat Adeleke A, Rammohan G, Jeanomond R. Retrograde Gastrojejunostomy Tube Migration. Case Reports in Emergency Medicine, 2014: 1–3. Adeleke A, Rammohan G, Jeanomond R. Retrograde Gastrojejunostomy Tube Migration. Case Reports in Emergency Medicine, 2014: 1–3.
6.
Zurück zum Zitat Itkin M, DeLegge MH, Fang JC, McClave SA, Kundu S, d’Othee BJ, Martinez-Salazar GM, Sacks D, Swan TL, Towbin RB, Walker TG, Wojak JC, Zuckerman DA, Cardella JF. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and cardiovascular and Interventional Radiological Society of Europe (CIRSE). Journal of Vascular and Interventional Radiology, 2011; 22(8): 1089–1106.CrossRefPubMed Itkin M, DeLegge MH, Fang JC, McClave SA, Kundu S, d’Othee BJ, Martinez-Salazar GM, Sacks D, Swan TL, Towbin RB, Walker TG, Wojak JC, Zuckerman DA, Cardella JF. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and cardiovascular and Interventional Radiological Society of Europe (CIRSE). Journal of Vascular and Interventional Radiology, 2011; 22(8): 1089–1106.CrossRefPubMed
7.
Zurück zum Zitat Kalkan IH, Dişibeyaz S, Önder FO, Oztas E, Odemis B, Ozogul Y, Parlak E. A rare complication of percutaneous endoscopic gastrojejunostomy (PEG-J): duodenal bulb perforation due to retrograde migration, Acta Gastro-Enterologica Belgica, 2012; 75(2): 276–277.PubMed Kalkan IH, Dişibeyaz S, Önder FO, Oztas E, Odemis B, Ozogul Y, Parlak E. A rare complication of percutaneous endoscopic gastrojejunostomy (PEG-J): duodenal bulb perforation due to retrograde migration, Acta Gastro-Enterologica Belgica, 2012; 75(2): 276–277.PubMed
8.
Zurück zum Zitat Zschau N, Nguyen N, Tam W, Schoeman M. Intestinal perforation: a rare complication of percutaneous endoscopic jejunostomy removal. Endoscopy, 2008; 40(2): article E178. Zschau N, Nguyen N, Tam W, Schoeman M. Intestinal perforation: a rare complication of percutaneous endoscopic jejunostomy removal. Endoscopy, 2008; 40(2): article E178.
9.
Zurück zum Zitat Weltz AS, Harris DG, O’Neill NA, O’Meara LB, Brenner ML, Diaz JJ. The use of resuscitative endovascular balloon occlusion of the aorta to control hemorrhagic shock during vídeo-assisted retroperitoneal debridement or infected necrotizing pancreatitis. Int J Surg Case Rep, 2015; 13: 15-18, 2015.CrossRef Weltz AS, Harris DG, O’Neill NA, O’Meara LB, Brenner ML, Diaz JJ. The use of resuscitative endovascular balloon occlusion of the aorta to control hemorrhagic shock during vídeo-assisted retroperitoneal debridement or infected necrotizing pancreatitis. Int J Surg Case Rep, 2015; 13: 15-18, 2015.CrossRef
10.
Zurück zum Zitat Keller BA, Salcedo ES, Williams TK, Neff LP, Carden AJ, Li Y, Gotlib O, Tran NK, Galante JM. Design of a cost-effective, hemodynamically adjustable model for resuscitative endovascular balloon occlusion of the aorta (REBOA) stimulation. J Trauma Acute Care Surg, 2016; 81(3): 606-11.CrossRefPubMed Keller BA, Salcedo ES, Williams TK, Neff LP, Carden AJ, Li Y, Gotlib O, Tran NK, Galante JM. Design of a cost-effective, hemodynamically adjustable model for resuscitative endovascular balloon occlusion of the aorta (REBOA) stimulation. J Trauma Acute Care Surg, 2016; 81(3): 606-11.CrossRefPubMed
11.
Zurück zum Zitat Doig F, Naidoo R, Sharma V, Tesar P. A unique hybrid approach to complex re-do aortic root surgery. Heart Lung Circ, 2017; 26(11): e68-e70.CrossRefPubMed Doig F, Naidoo R, Sharma V, Tesar P. A unique hybrid approach to complex re-do aortic root surgery. Heart Lung Circ, 2017; 26(11): e68-e70.CrossRefPubMed
Metadaten
Titel
The occlusion balloon reduction technique for de novo placement and salvage of malpositioned enteric tubes
verfasst von
Jeffrey Forris Beecham Chick
Neil Jairath
Jacob J. Bundy
Arjun Adapa
James J. Shields
Anthony N. Hage
Ravi N. Srinivasa
Publikationsdatum
07.05.2019
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 8/2019
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-019-02029-9

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