Definition of Postoperative Anatomy and Placement of PEJ

  • Manuel Berzosa Corella
  • Frank LukensEmail author


In this chapter, we will address two topics that will be useful for any endoscopist performing small bowel enteroscopy. First we will review some basic principles to keep in mind when scoping patients with altered small bowel anatomy. We will review the expected anatomy for the most common small bowel surgeries and discuss some tips that might be useful for navigating through the small bowel of these patients. The second half of the chapter will focus on the indications, technique, and adverse events of percutaneous endoscopic jejunostomy placement.


Small bowel anatomy Postoperative anatomy Percutaneous endoscopic jejunostomy PEJ Resection Anastomosis End-to-side anastomosis Side-to-side anastomosis Billroth I Billroth II Braun anastomosis Roux-en-Y gastrojejunal bypass (RYGB) Biliopancreatic diversion with a duodenal switch 

Supplementary material

Video 14.1

End-to-side anastomosis

Video 14.2

Side-to-side anastomosis. Small bowel anastomosis with 3 stomal openings

Video 14.3

Peristalsis and antiperistalsis at a small bowel anastomosis

Video 14.4

Billroth II anastomosis

Video 14.5

Roux-en-Y gastric bypass


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of GastroenterologyMayo Clinic FloridaJacksonvilleUSA

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