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Direct Percutaneous Endoscopic Jejunostomy for the Management of Gastroparesis in Pregnancy

Rupani, Sawan, Vijay; Ergen, William, F., MD; Weber, Frederick, MD; Peter, Shajan, MD

doi: 10.1097/AOG.0000000000002583
Contents: Case Reports

BACKGROUND: Providing meaningful nutrition in cases of refractory hyperemesis during pregnancy can be challenging; although intragastric enteral nutrition is the most common approach, it is contraindicated in certain cases and carries the risk of increased nausea and vomiting.

CASE: A 36-year-old primigravid woman with a history of gastroparesis presented at 16 weeks of gestation with nausea and vomiting. With no improvement with conventional approaches and signs of malnutrition, a direct percutaneous endoscopic jejunostomy was placed. Her nutritional status improved, and the pregnancy ended in the delivery of a healthy neonate.

CONCLUSION: Direct percutaneous endoscopic jejunostomy in pregnancy is an option in patients in whom intragastric feeding is contraindicated and may offer a more secure approach than percutaneous gastrojejunostomy.

Direct percutaneous endoscopic jejunostomy is a reasonable enteral feeding option in pregnancy.

Division of Gastroenterology, University of Alabama at Birmingham, Birmingham, Alabama; and the University College Dublin, School of Medicine and Medical Sciences, Dublin, Ireland.

Corresponding author: Sawan Vijay Rupani, email:

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.