Pediatric surgery international · 2025
Intussusception around jejunal feeding tubes in pediatric patients: a retrospective two-center experience and management strategies.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Mokhaberi Nariman, Madadi-Sanjani Omid, Armbrust Lina, Körner Merle, Görges Johannes, Tegtmeyer Daniel, Schulz-Jürgensen Sebastian, Reinshagen Konrad, Tomuschat Christian
Аннотация
INTRODUCTION: Jejunal feeding via endoscopic, fluoroscopic, or surgical tube placement is widely used in pediatrics. A rare complication is intussusception around the jejunal feeding tube (JFT), which can cause obstruction or bowel ischemia. This study evaluated risk factors and management strategies.
METHODS: We retrospectively reviewed all children undergoing JFT placement or revision at two centers (2014-2025). Patient and procedural data were analyzed.
RESULTS: Among 58 patients (163 procedures), 7 children (12%) developed 8 episodes of intussusception. Median age at placement was 1 year (IQR 5); intussusception occurred a median of 1.16 years later (IQR 4.38). Five episodes resolved spontaneously, 2 by hydrostatic reduction, and 1 during unrelated surgery. Neurological impairment was present in 62% of patients. Kaplan-Meier analysis showed the highest risk within 1-2 years post-placement. Events occurred after endoscopic (6/43), surgical (1/13), and fluoroscopic (1/2) placements, with no clear link to technique.
CONCLUSION: Intussusception around a JFT is rare but clinically significant. It should be suspected in children with abdominal pain, bilious vomiting, or feeding intolerance. Most cases can be managed non-surgically; our algorithm supports ultrasound diagnosis, observation or hydrostatic reduction, and surgery only for ischemia or failed conservative treatment.
METHODS: We retrospectively reviewed all children undergoing JFT placement or revision at two centers (2014-2025). Patient and procedural data were analyzed.
RESULTS: Among 58 patients (163 procedures), 7 children (12%) developed 8 episodes of intussusception. Median age at placement was 1 year (IQR 5); intussusception occurred a median of 1.16 years later (IQR 4.38). Five episodes resolved spontaneously, 2 by hydrostatic reduction, and 1 during unrelated surgery. Neurological impairment was present in 62% of patients. Kaplan-Meier analysis showed the highest risk within 1-2 years post-placement. Events occurred after endoscopic (6/43), surgical (1/13), and fluoroscopic (1/2) placements, with no clear link to technique.
CONCLUSION: Intussusception around a JFT is rare but clinically significant. It should be suspected in children with abdominal pain, bilious vomiting, or feeding intolerance. Most cases can be managed non-surgically; our algorithm supports ultrasound diagnosis, observation or hydrostatic reduction, and surgery only for ischemia or failed conservative treatment.