| Theme |
Endoscopic Treatment of Upper Gastrointestine: Current Status and Clinical Problems |
| Title |
Problems with Indications and Procedures in Percutaneous Endoscopic Jejunostomy (PEJ) |
| Author |
Hitoshi Shimao |
Keiai Iidabashi Clinic |
| Author |
Masaki Morise |
Department of Surgery, School of Medicine, Kitasato University |
| Author |
Shin-ichi Kuroyama |
Department of Surgery, School of Medicine, Kitasato University |
| Author |
Masahiko Watanabe |
Department of Surgery, School of Medicine, Kitasato University |
| [ Summary ] |
Percutaneous endoscopic jejunostomy (PEJ) is compared with percutaneous endoscopic gastrostomy (PEG). A PEJ catheter is placed through the PEG catheter which has previously been inserted, with the use of an endoscopically guided introduction from the stomach to a second portion of the duodenum or with a guidewire under X-ray controll. The management of enteral nutrition through a jejunostomy requires more care than that through a gastrostomy in terms of infusion speed and nutrient concentration. Therefore, PEJ should be limited to use only for patients where it is difficult to achieve interal controll through gastrostomy due to aspiration pneumonia with esophageal hiatus hernia or gastro-esophageal reflux. |