Endoscopy 2021; 53(12): E450-E451
DOI: 10.1055/a-1322-2062
E-Videos

Successful endoscopic retrieval of dislodged jejunostomy Foley catheter

Chu-Hsuan Kuo*
1  Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
2  Endoscopy Center, Division of Gastroenterology, Changhua Christian Hospital, Changhua Taiwan
,
Chia-Wei Yang*
2  Endoscopy Center, Division of Gastroenterology, Changhua Christian Hospital, Changhua Taiwan
,
2  Endoscopy Center, Division of Gastroenterology, Changhua Christian Hospital, Changhua Taiwan
3  School of Medicine, Chung Shan Medical University, Taichung, Taiwan
› Author Affiliations
Supported by: Changhua Christian Hospital 109-CCH-IRP-008
 

A 56-year-old man who had undergone placement of a feeding jejunostomy secondary to esophageal cancer presented believing that his feeding tube had fallen out but he was unable to locate it in his home. He had not experienced any abdominal pain, tarry stool, intestinal obstruction, or peritonitis. Radiological examination revealed that the missing jejunostomy Foley tube had migrated into the small intestine. Endoscopy failed to find the migrated tube, which remained stuck over the terminal ileum with proximal small bowel dilatation after 3 days ([Fig. 1]). We decided to perform endoscopic retrieval and the migrated tube with inflated balloon was found in the terminal ileum ([Fig. 2]). Attempts using snare or forceps all failed to pull out the impacted catheter due to adhesion resistance. We deflated the balloon after puncturing it with an injection needle ([Video 1]), and the Foley tube was successfully removed without resistance ([Fig. 3], [Fig. 4]).

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Fig. 1 Abdominal radiograph revealed the dislodged tube in the right lower abdomen. Proximal small bowel dilatation was observed.
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Fig. 2 Colonoscopy revealed the tip of the feeding tube in the terminal ileum with inflated balloon.

Video 1 A jejunostomy Foley tube became dislodged and migrated as far as the terminal ileum, where it became stuck. Attempts using snare or forceps all failed to pull out the impacted catheter. We deflated the balloon after puncturing it with an injection needle and the Foley tube was successfully removed.


Quality:
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Fig. 3 Balloon was deflated after injection needle puncture and retracted from the ileum.
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Fig. 4 Colonoscopic view of the retrieved catheter.

A jejunal tube is one of the common methods for providing enteral feeding access for nutritional support [1] when the oral route is restricted or not accessible [2]. Complications of the feeding tube, which include obstruction, intussusception, and migration of the tube, are uncommon [3]. Complete migration is rare and usually requires surgical intervention if bowel obstruction or peritoneal signs occur [4]. If, as in our patient, the tube is not spontaneously passed out, endoscopic retrieval should be attempted, leaving surgical removal as the last treatment option.

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Competing interests

The authors declare that they have no conflict of interest.

* Chu-Hsuan Kuo and Chia-Wei Yang contributed equally to the manuscript.



Corresponding author

Hsu-Heng Yen, MD
Endoscopy Center
Division of Gastroenterology
Changhua Christian Hospital
135, Nanhsiao Street
Changhua 500
Taiwan   
Fax: +886-7-7228289   

Publication History

Publication Date:
04 February 2021 (online)

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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Zoom Image
Fig. 1 Abdominal radiograph revealed the dislodged tube in the right lower abdomen. Proximal small bowel dilatation was observed.
Zoom Image
Fig. 2 Colonoscopy revealed the tip of the feeding tube in the terminal ileum with inflated balloon.
Zoom Image
Fig. 3 Balloon was deflated after injection needle puncture and retracted from the ileum.
Zoom Image
Fig. 4 Colonoscopic view of the retrieved catheter.