Johns Hopkins Manual for GI Endoscopic Nurses, Third Edition

Mouen Khashab, MD; Toshunia Robinson, MD; Anthony Kalloo, MD

Chapter 19: Percutaneous Endoscopic Jejunostomy Tube Placement: Endoscopic Nasoenteric Tube Placement (continued)

David W. Victor III, MD; Stuart K. Amateau, MD, PhD

Percutaneous endoscopic jejunostomy (PEJ) refers to the endoscopic placement of a feeding tube in the jejunum. This procedure is performed in patients with abnormal gastric emptying or severe gastroesophageal reflux with aspiration. Endoscopic jejunostomy tube placement may utilize gastrostomy access (transgastric jejunostomy) or occur through direct percutaneous access of the jejunum. This chapter describes the former. Direct PEJ is performed in a nearly identical fashion to percutaneous gastrostomy tube placement; however, it should only be performed by an expert proceduralist given the…