Abstract
Enteral jejunal feeding is indicated in patients who require enteral feeds but who are unable to tolerate intragastric feeding. These include patients with acute pancreatitis, patients with altered gastric anatomy after surgery, patients at high risk of aspiration pneumonia from gastric contents, and patients with gastroparesis. Enteral nutrition via a nasojejunal tube is suitable as a temporizing measure in these patients but not as a long-term option, because of patient discomfort and a propensity for accidental dislodgement. The 3 options for mediumto long-term jejunal feeding include a surgically placed jejunal tube, a percutaneous gastrostomy with jejunal extension (PEG/J), and a direct percutaneous endoscopic jejunostomy (DPEJ) tube. We describe a patient who underwent a DPEJ insertion complicated by necrotizing fasciitis.
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