Intussusception around jejunal feeding tubes in pediatric patients: a retrospective two-center experience and management strategies.

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.