Indian Journal of Surgery

, Volume 80, Issue 1, pp 14–18 | Cite as

Balloon-Inflated Catheters for Enteral Feeding: a Word of Caution

  • Nihar Ranjan Dash
  • Anand Narayan Singh
  • Ragini Kilambi
Original Article

Abstract

Catheters with inflatable balloons such as a Foley catheter may be used for feeding gastrostomy/jejunostomy. The incorrect or improper use of these catheters can have serious consequences. We report 13 cases of feeding jejunostomy with balloon-inflated catheter’s malfunction, some referred to our centre and others operated here over a period of 8 years. The most dramatic consequence of such improper use led to rupture of the small intestine due to inadvertent over-inflation (over 100 ml) of the balloon of the catheter during a contrast study. The patient required a laparotomy with resection and anastomosis of the bowel. Three other patients had similar over-inflation of the balloon leading to severe pain and discomfort. In all three patients, timely deflation of the balloon was sufficient to relieve the symptoms. One patient had intussusception with the inflated balloon acting as a lead point. The patient underwent resection of the small bowel with end jejunostomy and distal mucous fistula. All other patients presented with abdominal pain and distension and intestinal obstruction and were managed non-operatively with deflation of balloon either by aspiration, cutting the balloon port or ultrasound-guided puncture of balloon. Healthcare personnel dealing with patients with indwelling catheters must be educated to suspect, detect and manage such problems. The best measure for such unusual complications of otherwise safe devices would be prevention by training and generation of awareness.

Keywords

Catheter Feeding Jejunostomy Balloon Malfunction 

Notes

Authors’ Contributions

NRD revised the manuscript critically and provided intellectual content. ANS performed the acquisition, preparation and drafting of the manuscript. RK prepared and drafted the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Grant

No grant support/assistance.

Conflict of Interest

The authors declare that they have no competing interests.

References

  1. 1.
    Kadakia SC, Cassaday M, Shaffer RT (1992) Prospective evaluation of Foley catheter as a replacement gastrostomy tube. Am J Gastroenterol 87(11):1594–1597PubMedGoogle Scholar
  2. 2.
    Koulentaki M, Reynolds N, Steinke D, et al. (2002) Eight years’ experience of gastrostomy tube management. Endoscopy 34(12):941–945CrossRefPubMedGoogle Scholar
  3. 3.
    Gharib AM, Stern EJ, Sherbin VL, et al. (1996) Nasogastric and feeding tubes: the importance of proper placement. Postgrad Med 99(5):165–168 174-6CrossRefGoogle Scholar
  4. 4.
    Konda J, Ruggle P (1981) Prolapse of Foley catheter gastrostomy tube causing obstructive jaundice. Am J Gastroenterol 76(4):353–355PubMedGoogle Scholar
  5. 5.
    O'Keefe KP (1994) Complications of percutaneous feeding tubes. Emerg Med Clin North Am 12(3):815–826Google Scholar
  6. 6.
    Larson DE, Burton DD, Schroeder KW, et al. (1987) Percutaneous endoscopic gastrostomy. Indications, success, complications and mortality in 314 consecutive patients. Gastroenterology 93(1):48–52CrossRefPubMedGoogle Scholar
  7. 7.
    Wasiljew BK, Ujiki GT, Beal JM (1982) Feeding gastrostomy: complications and mortality. Am J Surg 143(2):194–195CrossRefPubMedGoogle Scholar
  8. 8.
    Thillainayagam AV, Dias JA, Mourad F, et al. (1991) Retention of non-deflating balloon in small bowel. Case report and review of the literature. Dig Dis Sci 36(10):1486–1488CrossRefPubMedGoogle Scholar
  9. 9.
    Kadakia SC, Cassaday M, Shaffer RT (1994) Comparison of Foley catheter as a replacement gastrostomy tube with commercial replacement gastrostomy tube: a prospective randomized trial. Gastrointest Endosc 40(2 Pt 1):188–193CrossRefPubMedGoogle Scholar
  10. 10.
    Merrick HW, Howard JM (1990) Intestinal obstruction by distension of a Foley jejunostomy catheter. JPEN J Parenter Enteral Nutr 14(6):660–661CrossRefPubMedGoogle Scholar
  11. 11.
    Yassa NA (1999) Iatrogenic bowel obstruction caused by balloon-inflated feeding tubes. Can Assoc Radiol J 50(2):98–100PubMedGoogle Scholar
  12. 12.
    Date RS, Das N, Bateson PG (2002) Unusual complications of ballooned feeding tubes. Ir Med J 95(6):181–182PubMedGoogle Scholar
  13. 13.
    Cunningham S, Best C (2013) Guidelines for routine gastrostomy tube replacement in children. Nurs Child Young People 25(10):22–25CrossRefPubMedGoogle Scholar

Copyright information

© Association of Surgeons of India 2016

Authors and Affiliations

  • Nihar Ranjan Dash
    • 1
  • Anand Narayan Singh
    • 1
  • Ragini Kilambi
    • 1
  1. 1.Department of Gastrointestinal Surgery and Liver TransplantationAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations