Percutaneous endoscopic jejunostomy tube placement for treatment of severe hyperemesis gravidarum in pregnancy
Kruchko D, Shah N, Broy C, Silas D. Percutaneous Endoscopic Jejunostomy Tube Placement for Treatment of Severe Hyperemesis Gravidarum in Pregnancy. J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620975954. doi: 10.1177/2324709620975954. PMID: 33238753; PMCID: PMC7705777
Hyperemesis gravidarum is a common disease. Most patients are effectively treated with conservative measures, but gastric feeding and, rarely, post-pyloric feeding can be necessary. A 27-year-old woman, G3P2002, with a history of refractory hyperemesis in previous pregnancies, required placement of a nasojejunal tube but was removed due to an oropharyngeal ulcer. Endoscopic placement of a percutaneous endoscopic transgastric-jejunostomy (PEG-J) tube caused resolution of her symptoms. Twelve days after placement, the distal tube became dislodged and was endoscopically replaced with hemoclip anchoring in the jejunum. PEG-J tube placement is a safe and effective option for nutritional support in refractory hyperemesis gravidarum.