Jejunostomy

{{Short description|Surgical opening of the skin}}

{{Infobox medical intervention |

Name = Jejunostomy |

Image = Jejunostomy.jpg|

Caption = Jejunostomy to the abdomen wall|

ICD10 = |

ICD9 = {{ICD9proc|46.32}} |

MeshID = D007582 |

OtherCodes = }}

Jejunostomy is the surgical creation of an opening (stoma) through the skin at the front of the abdomen and the wall of the jejunum (part of the small intestine). It can be performed either endoscopically, or with open surgery.{{cite journal |doi=10.1136/pmj.78.918.198 |title=Enteral feeding. Nasogastric, nasojejunal, percutaneous endoscopic gastrostomy, or jejunostomy: Its indications and limitations |year=2002 |last1=Pearce |first1=C B |journal=Postgraduate Medical Journal |volume=78 |issue=918 |pages=198–204 |pmid=11930022 |last2=Duncan |first2=HD |pmc=1742333}}

A jejunostomy may be formed following bowel resection in cases where there is a need to bypass the distal small bowel and/or colon due to a bowel leak or perforation. Depending on the length of jejunum resected or bypassed the patient may have resultant short bowel syndrome and require parenteral nutrition.{{cite journal |doi=10.1136/gut.2006.091108 |title=Guidelines for management of patients with a short bowel |year=2006 |last1=Nightingale |first1=J |journal=Gut |volume=55 |pages=iv1–12 |pmid=16837533 |last2=Woodward |first2=JM |author3=Small Bowel Nutrition Committee of the British Society of Gastroenterology |pmc=2806687 |issue=Suppl 4}}

A jejunostomy is different from a jejunal feeding tube. A jejunal feeding tube is an alternative to a gastrostomy feeding tube and is commonly used when gastric enteral feeding is contraindicated or carries significant risks. The advantage over a gastrostomy is its low risk of aspiration due to its distal placement. Disadvantages include small bowel obstruction, ischemia, and requirement for continuous feeding.{{Cite journal|pmid=16847244|journal=Arch Surg|date=July 2006|volume=141|issue=7|pages=701–4|title=Bowel necrosis associated with early jejunal tube feeding: A complication of postoperative enteral nutrition|author=Melis M1 |author2=Fichera A |author3=Ferguson MK. |doi=10.1001/archsurg.141.7.701|doi-access=free}}