Case Reports Massive Pneumatosis Intestinalis and Subcutaneous Emphysema: Complication of Needle Catheter Jejunostomy

ABSTRACT. The safety and efficacy of enteral feeding by needle catheter jejunostomy has prompted its use after many major gastrointestinal operations. Indeed, the technical com-plications of this procedure are infrequent. This report details the development of massive pneumatosis intestinalis associated with elemental feeding via jejunostomy. The proposed etiology includes excessive gas accumulation within the small intestine secondary to 1) inadequate nasogastric suction, 2) post-trau-matic intestinal ileus, and 3) disaccharide fermentation com-bined with a mucosal defect created by the catheter jejunos-tomy. Successful management consists of nasogastric suction and immediate termination of the enteral feeding. The development of elemental diets and recent ad-vances in the technique of needle catheter jejunostomy have reawakened interest in enteral feeding during th