Migrated Feeding Tube: A Rare Complication of Distal Feeding Enteroclysis

Abstract

In emergency, often a proximal stoma is created in view of compromised general condition of the patient (severe sepsis, malnutrition, hypoalbuminemia, vasopressor support, multiorgan dysfunction) while operating for intestinal obstruction, perforation, bleeding, or ischemia etc. The proximal stoma results in high output and consequent fluid and electrolyte deficit. Refeeding or enteroclysis of succus entericus into the distal mucous fistula is a well-known strategy in such patients. It reduces dependence on parenteral nutrition and facilitates faster transition to acceptable and sustainable home based therapy till the restoration of bowel continuity. Although this is an effective and safe procedure, certain known complications like non-tolerance to the refeed, bowel perforation, diarrhoea, and peristomal skin excoriation have been reported. Migration of entire Foley’s catheter used for distal reefed, getting entrapped at IC junction is a rare complication. We, present a case of 59-years gentleman of abdominal tuberculosis, who presented with lower GI bleeding. He underwent laparotomy and diagnostic enteroscopy and ended-up having a proximal stoma. He received ATT post-operatively and distal refeeding through a Foley’s catheter. After 1.5 months, he presented with migration of feeding catheter. Endoscopic retrieval was unsuccessful. Thus, exploratory laparotomy and retrieval of feeding catheter was done. This was a rare complication in usual surgical practice which could have been prevented with proper patient counselling.