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Complications of nasojejunal tube insertion in the neonate
  1. Aoife Hurley1,
  2. Joseph Wiltshire2,
  3. Lawrence Miall1
  1. 1 Neonatal Medicine, Leeds General Infirmary, Leeds, UK
  2. 2 Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Aoife Hurley, Leeds Teaching Hospitals NHS Trust, Leeds, UK; ahurley{at}doctors.org.uk

https://doi.org/10.1136/archdischild-2021-322669

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    Background

    On ward-round, a male patient born at 26+2 weeks, who is now term corrected weighing 1.61 kg, is being reviewed. Previously, he had significant renal impairment secondary to a patent ductus arteriosus (PDA), which was ligated day 25 of life and renal function improved. His issues now include poor weight gain, vomiting, hyperparathyroidism, bilateral nephrocalcinosis and anaemia. He had necrotising enterocolitis (NEC) successfully medically managed 6 weeks prior to this review. Despite optimising medical reflux management and nutritional intake, vomiting and weight gain remained problematic. The decision was made for nasojejunal tube (NJT). He had a size 8 fr silk NJT inserted, with guidewire removed from NJT before insertion.

    Figure 1

    Abdominal AP X-ray film demonstrating NGT (thinner) and NJT (whiter and thicker) in situ. AP, anteroposterior; NJT, nasojejunal tube.

    Test your knowledge

    1. What should you do after reviewing figure 1?

      1. Commence feeds

      2. Advance NJT, recheck with further X-rays prior to feeding

      3. Advance NJT, commence feed if it advances easily

      4. Remove NJT

      5. Refer to interventional radiology for …

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    Footnotes

    • Twitter @DrMiall

    • Contributors AH wrote the first draft, subsequently reviewed and revised by JW and AH before final draft reviewed by LM.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.