MyMedR

Fulltext Jejunal diverticulosis as the obscure cause of overt gastrointestinal bleeding

Nyin LY, Zainun AR, Tee HP

Med J Malaysia, 2011 Aug;66(3):257-8.

Jejunal diverticulosis is a rare gastrointestinal condition manifested as benign outpouching from the jejunal wall. It is usually asymptomatic, but may present as obscure gastrointestinal bleeding. This condition is often found incidentally in the imaging work-up of patients with other gastrointestinal conditions. We present a case of jejunal diverticulosis in a 65-year-old gentleman with obscure overt gastrointestinal bleed.

Matched MeSH terms: Jejunal Diseases/diagnosis*; Jejunal Diseases/therapy

Fulltext Perforation of duodeno-jejunal junction in an 8-month-old infant: a management challenge to a general surgeon

Limi L, Anita AA, Liew NC, Safian M

Med J Malaysia, 2011 Jun;66(2):158-9.

PMID: 22106704 MyJurnal

We report a case of perforation over duodeno-jejunal junction (DJ) in a healthy 8-month-old baby. The difficulty in diagnosis, management dilemma and probable etiology is discussed.

Matched MeSH terms: Jejunal Diseases/diagnosis*; Jejunal Diseases/etiology; Jejunal Diseases/surgery*

Fulltext Acute retrograde jejunogastric intussusception 20 years after Bilroth II gastrectomy: a case report

Sakijan AS, Ahmad I

Med J Malaysia, 1987 Jun;42(2):134-6.

PMID: 3503189

A 50-year-old male had an acute jejunogastric intussusception complicating a Bilroth 11 gastrectomy done 20 years previously for peptic ulcer. Preoperatively, the diagnosis was suspected from the plain abdominal radiograph which was subsequently confirmed by barium meal. The patient had an uneventful recovery following resection of the intussuscepted segment and an end-to-end anastomosis. Although rare, the condition is serious and should be recognised promptly and treated surgically. The diagnosis should always be considered in a patient who has had a previous gastrojejunostomy presented with a sudden onset of epigastric pain, bloody vomitus and epigastric mass.

Matched MeSH terms: Jejunal Diseases/etiology*

Calibre persistent submucosal artery of the jejunum: a rare cause of massive gastrointestinal bleeding

Wan Muhaizan WM, Julia MJ, Al Amin D

Malays J Pathol, 2002 Dec;24(2):113-6.

PMID: 12887171

Historically a calibre persistent submucosal artery was most often described in the stomach. However in later years it was also discovered in the duodenum and jejunum. It is an uncommon and important cause of massive gastrointestinal bleeding in which failure of detection and early intervention would lead to death. In this paper we report a 27-year-old man with no significant medical history who presented at the emergency unit for recurrent melaena, haematochezia and hypotension. Initial investigations failed to localize the source of bleeding. Emergency exploratory laporatomy revealed a small jejunal mucosal nodule that was actively spurting blood. Histopathological evaluation identified a calibre persistent submucosal artery.

Matched MeSH terms: Jejunal Diseases/complications*; Jejunal Diseases/pathology; Jejunal Diseases/surgery

Peutz-Jeghers syndrome and its complications. First case report from Malaysia with review of literature

Joishy SK, Leela MP, Balasegaram M

Am J Surg, 1979 Nov;138(5):716-20.

PMID: 495861

We report for the first time from Malaysia a patient with Peutz-Jeghers syndrome complicated by successive intussusceptions requiring extensive small bowel resection. Our experience is compared with that of other authors by a review of the literature highlighting important points in the diagnosis and management of complications in Peutz-Jeghers syndrome.

Matched MeSH terms: Jejunal Diseases/etiology; Jejunal Diseases/surgery*

Jejunal perforation complicating PEG insertion in a child

Meng Boey CC, Goh KL, Sithasanan N, Goh DW

Gastrointest Endosc, 2002 Apr;55(4):607-8.

PMID: 11923788

Matched MeSH terms: Jejunal Diseases/diagnosis; Jejunal Diseases/etiology*

A rare case of intussusception associated with metastasized small cell carcinoma of lung

Jarmin R, Azman A, Rahim R, Kosai NR, Das S

Acta Med Iran, 2012;50(11):782-4.

PMID: 23292632

Intussusception is common cause of bowel obstruction in the paediatric age group compared to the elderly population. Many times, the diagnosis may be difficult because of asymptomatic nature of this bowel disorder. We hereby describe the case of a 75-year-old male who presented with lethargy, weakness, loss of movement in the joints and was found to be anemic. The haemoglobin level was low so he was transfused with packed cells. On gastrointestinal (GI) endoscopy, upper GI bleed was observed. A mass was observed beyond ampulla at the 2nd and 3rd part of the duodenal junction. Computerized tomography (CT) scan also showed a mass at the head of pancreas and the lesion at the left lung. In view of persistent bleed, 'Whipple's procedure' was performed. Histopathological examination showed small cell carcinoma of the lungs with metastasis to the pancreas and the jejunum. We here discuss the case of intussusception with intestinal metastasis which presented with gastrointestinal bleeding.

Matched MeSH terms: Jejunal Diseases/etiology; Jejunal Diseases/radiography; Jejunal Diseases/surgery

A Novel Method of Nasojejunal Feeding and Gastric Decompression Using a Double Lumen Silicone Tube for Upper Gastrointestinal Obstruction

Tan JH, Sivadurai G, Tan HCL, Tan YR, Jahit S, Hans Alexander M

Surg Laparosc Endosc Percutan Tech, 2020 Apr;30(2):106-110.

PMID: 31923160 DOI: 10.1097/SLE.0000000000000754

BACKGROUND: Provision of enteral nutrition with jejunal feeding in upper gastrointestinal obstruction is highly recommended. Access to jejunum can be obtained surgically, percutaneously, or endoscopically. Our institution routinely and preferentially utilizes a silicone nasojejunal tube that is inserted past the obstruction endoscopically. We use a custom dual channel tube that allows feeding at the distal tip and another channel 40 cm from the tip that enables decompression proximally. This is a report of our experience with this custom nasojejunal tube.

METHODS: This is a prospective observational study of 201 patients who underwent endoscopic nasojejunal wire-guided feeding tube insertions for obstruction of either the esophagus or the stomach including both benign and malignant pathologies between January 2015 to June 2018 in Hospital Sungai Buloh and Hospital Sultanah Aminah, Malaysia. The indications for tube insertion, insertion technique, and tube-related problems were described.

RESULTS: The nasojejunal tube was used to establish enteral feeding in patients with obstructing tumors of the distal esophagus in 65 patients (32.3%) and gastric outlet obstruction in 72 patients (35.8%). There were 54 patients (26.9%) who required reinsertion. The most common reason for reinsertion was unintentional dislodgement, where 32 patients (15.9%) followed by tube blockage 20 patients (10.0%). Using our method of advancement under direct vision, we had only 2 cases of malposition due to severely deformed anatomy. We had no incidence of aspiration in this group of patients and overall, the patients tolerated the tube well.

CONCLUSIONS: The novel nasojejunal feeding tube with gastric decompression function is a safe and effective method of delivery of enteral nutrition in patients with upper gastrointestinal obstruction. These tubes if inserted properly are well tolerated with almost no risk of malposition and are tolerated well even for prolonged periods of time until definitive surgery could be performed.

Matched MeSH terms: Jejunal Diseases/surgery*

Displaying all 8 publications