# Jejunostomy

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> Markdown URL: https://mediated.wiki/source/Jejunostomy.md
> Source: https://en.wikipedia.org/wiki/Jejunostomy
> Source revision: 1332834179
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{{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](/source/jejunum) (part of the [small intestine](/source/small_intestine)). It can be performed either [endoscopically](/source/endoscopy), or with [open surgery](/source/open_surgery).<ref name="Pearce">{{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}}</ref>

A jejunostomy may be formed following [bowel resection](/source/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](/source/short_bowel_syndrome) and require [parenteral nutrition](/source/parenteral_nutrition).<ref name="Nightingale">{{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}}</ref>

A jejunostomy is different from a jejunal [feeding tube](/source/feeding_tube). A jejunal feeding tube is an alternative to a [gastrostomy](/source/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](/source/Pulmonary_aspiration) due to its distal placement. Disadvantages include [small bowel](/source/small_bowel) obstruction, [ischemia](/source/ischemia), and requirement for continuous feeding.<ref>{{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}}</ref>

==Techniques==

The '''Witzel jejunostomy''' is the most common method of jejunostomy creation.<ref name="Tapia">{{cite journal |vauthors=Tapia J, Murguia R, Garcia G, de los Monteros PE, Oñate E |year=1999 |title=Jejunostomy: techniques, indications, and complications |journal=World Journal of Surgery |volume=23 |issue=6 |pages=596–602 |doi= 10.1007/pl00012353|pmid=10227930 |s2cid=21517953 }}</ref>  It is an open technique where the jejunosotomy is sited 30&nbsp;cm distal to the [Ligament of Treitz](/source/Ligament_of_Treitz) on the antimesenteric border, with the catheter tunneled in a seromuscular groove.{{cn|date=January 2022}}

== References ==
{{reflist}}

{{Stomas}}
{{Digestive system surgical procedures}}

Category:Enteral feeding
Category:Digestive system surgery

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Adapted from the Wikipedia article [Jejunostomy](https://en.wikipedia.org/wiki/Jejunostomy) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Jejunostomy?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.