Intestinal Dysmotility and the Risk of Volvulus Following Omega-Jejunostomy Tube Placement in Children
Abstract
INTRODUCTION: Gastric dysmotility complicates enteral feeding in children, often requiring distal feeding access. While nasoduodenal and gastrojejunostomy tubes are common, frequent dislodgements necessitate hospital visits for fluoroscopic-guided replacement, exposing children to radiation and potential anesthesia risks. The omega-jejunostomy (OJ) tube was developed as a simpler alternative to roux-en-Y feeding jejunostomy, allowing easy at-home tube changes after tract maturation. Despite nearly two decades of use, OJ-tube placement remains poorly characterized. This study examines patient factors and outcomes following OJ-tube placement in children at a single center.
METHODS: A retrospective review was conducted on 23 pediatric patients who underwent OJ-tube placement at an academic children's hospital (2016-2024). We analyzed demographic, perioperative, and outcome data, including volvulus incidence, reoperations, emergency department (ED) visits, and readmissions.
RESULTS: Intestinal volvulus occurred in 17.4 % (n = 4), requiring emergent laparotomy. Patients with volvulus had longer hospital stays (12.0 vs. 3.5 days, p = 0.02) and higher 30-day readmission rates (100 % vs. 15.8 %, p = 0.004). Intestinal dysmotility was present in 75 % of volvulus cases, suggesting a predisposition (p = 0.07). ED visits occurred in 73.9 % of patients, primarily due to clogged (35.3 %) or dislodged tubes (29.4 %).
DISCUSSION: OJ-tube placement is an effective feeding option but carries…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 23 participants or records.
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