Endoscopic jejunal access for enteral feeding

Enteral (gat) alimentation appears to offer greater benefit for patients than calories delivered via a parenteral (intravenous) route. Enteral alimentation prevents mucosal atrophy, maintains normal gut flora, decreases bacterial translocation, and enhances enteral immunological competence. Reliable delivery into the jejunum without the placement of an operative feeding tube is difficult, however. We have been interested for some time in endoscopically placing a jejunal tube for enteral nutrition early (within 24 hours) after trauma resuscitation or operation. A simplified technique is described for the endoscopic placement of a jejunal feeding tube, with or without a concomitant percutaneous endoscopic gastrostomy.