{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T09:32:12Z","timestamp":1763631132931,"version":"3.45.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Jejunal feeding via endoscopic, fluoroscopic, or surgical tube placement is widely used in pediatrics. A rare complication is intussusception around the jejunal feeding tube (JFT), which can cause obstruction or bowel\u00a0ischemia. This study evaluated risk factors and management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed all children undergoing JFT placement or revision at two centers (2014\u20132025). Patient and procedural data were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 58 patients (163 procedures), 7 children (12%) developed 8 episodes of intussusception. Median age at placement was 1 year (IQR 5); intussusception occurred a median of 1.16 years later (IQR 4.38). Five episodes resolved spontaneously, 2 by hydrostatic reduction, and 1 during unrelated surgery. Neurological impairment was present in 62% of patients. Kaplan\u2013Meier analysis showed the highest risk within 1\u20132 years post-placement. Events occurred after endoscopic (6\/43), surgical (1\/13), and fluoroscopic (1\/2) placements, with no clear link to technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intussusception around a JFT is rare but clinically significant. It should be suspected in children with abdominal pain, bilious vomiting, or feeding intolerance. Most cases can be managed non-surgically; our algorithm supports ultrasound diagnosis, observation or hydrostatic reduction, and surgery only for ischemia or failed conservative treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-025-06209-1","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T05:13:31Z","timestamp":1759382011000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intussusception around jejunal feeding tubes in pediatric patients: a retrospective two-center experience and management strategies"],"prefix":"10.1007","volume":"41","author":[{"given":"Nariman","family":"Mokhaberi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omid","family":"Madadi-Sanjani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Armbrust","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merle","family":"K\u00f6rner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"G\u00f6rges","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Tegtmeyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Schulz-J\u00fcrgensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konrad","family":"Reinshagen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Tomuschat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,2]]},"reference":[{"key":"6209_CR1","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/j.jpedsurg.2018.10.078","volume":"54","author":"C Mccann","year":"2018","unstructured":"Mccann C, Cullis PS, Mccabe AJ, Munro FD (2018) Major complications of jejunal feeding in children. J Pediatr Surg 54:258\u2013262. https:\/\/doi.org\/10.1016\/j.jpedsurg.2018.10.078","journal-title":"J Pediatr Surg"},{"key":"6209_CR2","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1111\/j.1572-0241.2005.40893.x","volume":"100","author":"JE Fortunato","year":"2005","unstructured":"Fortunato JE, Darbari A, Mitchell SE et al (2005) The limitations of gastro-jejunal (G-J) feeding tubes in children: a 9-year pediatric hospital database analysis. Am J Gastroenterol 100:186\u2013189. https:\/\/doi.org\/10.1111\/j.1572-0241.2005.40893.x","journal-title":"Am J Gastroenterol"},{"key":"6209_CR3","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1046\/j.1440-1746.2000.02004.x","volume":"15","author":"FB Nicholson","year":"2000","unstructured":"Nicholson FB, Korman MG, Richardson MA (2000) Percutaneous endoscopic gastrostomy: a review of indications, complications and outcome. J Gastroenterol Hepatol 15:21\u201325. https:\/\/doi.org\/10.1046\/j.1440-1746.2000.02004.x","journal-title":"J Gastroenterol Hepatol"},{"key":"6209_CR4","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1097\/MPG.0000000000002379","volume":"69","author":"IJ Broekaert","year":"2019","unstructured":"Broekaert IJ, Falconer J, Bronsky J et al (2019) The use of jejunal tube feeding in children: a position paper by the gastroenterology and nutrition committees of the European society for paediatric gastroenterology, hepatology, and nutrition 2019. J Pediatr Gastroenterol Nutr 69:239\u2013258. https:\/\/doi.org\/10.1097\/MPG.0000000000002379","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"6209_CR5","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1055\/s-2007-964929","volume":"17","author":"A Williams","year":"2007","unstructured":"Williams A, Borsellino A, Sugarman I, Crabbe D (2007) Roux-en-Y feeding jejunostomy in infants and children. Eur J Pediatr Surg 17:29\u201333. https:\/\/doi.org\/10.1055\/s-2007-964929","journal-title":"Eur J Pediatr Surg"},{"key":"6209_CR6","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.jpedsurg.2017.01.026","volume":"52","author":"J Morse","year":"2017","unstructured":"Morse J, Baird R, Muchantef K et al (2017) Gastrojejunostomy tube complications \u2014 a single center experience and systematic review. J Pediatr Surg 52:726\u2013733. https:\/\/doi.org\/10.1016\/j.jpedsurg.2017.01.026","journal-title":"J Pediatr Surg"},{"key":"6209_CR7","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1093\/bjs\/znad034","volume":"110","author":"O Madadi-Sanjani","year":"2023","unstructured":"Madadi-Sanjani O, Kuebler JF, Brendel J et al (2023) Implementation and validation of a novel instrument for the grading of unexpected events in paediatric surgery: Clavien-Madadi classification. Br J Surg 110:576\u2013583. https:\/\/doi.org\/10.1093\/bjs\/znad034","journal-title":"Br J Surg"},{"key":"6209_CR8","doi-asserted-by":"publisher","first-page":"1672","DOI":"10.1016\/j.jpedsurg.2024.03.022","volume":"59","author":"O Madadi-Sanjani","year":"2024","unstructured":"Madadi-Sanjani O, Kuebler JF, Brendel J et al (2024) Validation of the Clavien-Madadi classification for unexpected events in pediatric surgery: a collaborative ERNICA project. J Pediatr Surg 59:1672\u20131679. https:\/\/doi.org\/10.1016\/j.jpedsurg.2024.03.022","journal-title":"J Pediatr Surg"},{"key":"6209_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.06.014","author":"J Picoraro","year":"2015","unstructured":"Picoraro J, Pierog A, Reilly N, Mencin A (2015) Gastrojejunal tube placement through an established gastrostomy via an endoscopic transgastric approach in a pediatric population. Gastrointest Endosc. https:\/\/doi.org\/10.1016\/j.gie.2015.06.014","journal-title":"Gastrointest Endosc"},{"key":"6209_CR10","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.carj.2011.09.003","volume":"64","author":"D Jaskolska","year":"2012","unstructured":"Jaskolska D, Brown N, Cohen E et al (2012) Evaluating the implementation of a quality improvement initiative: weekend gastrojejunostomy tube maintenance service in a tertiary pediatric center. Can Assoc Radiol J 64:229\u2013235","journal-title":"Can Assoc Radiol J"},{"key":"6209_CR11","doi-asserted-by":"publisher","first-page":"467","DOI":"10.2214\/ajr.170.2.9456966","volume":"170","author":"BL Connolly","year":"1997","unstructured":"Connolly BL, Chait PG, Siva-Nandan R et al (1997) Recognition of intussusception around gastrojejunostomy tubes in children. Am J Roentgenol 170:467\u2013470. https:\/\/doi.org\/10.2214\/ajr.170.2.9456966","journal-title":"Am J Roentgenol"},{"key":"6209_CR12","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1007\/s002470000260","volume":"30","author":"UM Hughes","year":"2000","unstructured":"Hughes UM, Connolly BL, Chait PG, Muraca S (2000) Further report of small-bowel intussusceptions related to gastrojejunostomy tubes. Pediatr Radiol 30:614\u2013617. https:\/\/doi.org\/10.1007\/s002470000260","journal-title":"Pediatr Radiol"},{"key":"6209_CR13","doi-asserted-by":"publisher","first-page":"e19888","DOI":"10.1097\/MD.0000000000019888","volume":"99","author":"T Kakiuchi","year":"2020","unstructured":"Kakiuchi T, Nakayama A, Nojiri J et al (2020) Jejuno-jejunal intussusception caused by a percutaneous endoscopic gastrojejunostomy tube in a pediatric patient: a case report. Medicine (Baltimore) 99:e19888. https:\/\/doi.org\/10.1097\/MD.0000000000019888","journal-title":"Medicine (Baltimore)"},{"key":"6209_CR14","unstructured":"Weilbaecher D, Bolin JA Hearn D intussusception in adults"},{"key":"6209_CR15","doi-asserted-by":"publisher","first-page":"407","DOI":"10.3748\/wjg.15.407","volume":"15","author":"A Marinis","year":"2009","unstructured":"Marinis A, Yiallourou A, Samanides L et al (2009) Intussusception of the bowel in adults: a review. World J Gastroenterol 15:407. https:\/\/doi.org\/10.3748\/wjg.15.407","journal-title":"World J Gastroenterol"},{"key":"6209_CR16","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.2233","author":"H Sakthivel","year":"2018","unstructured":"Sakthivel H, Sahoo AK, Amaranathan A et al (2018) A surgical conundrum in feeding jejunostomy-jejunojejunal intussusception: a case series. Cureus. https:\/\/doi.org\/10.7759\/cureus.2233","journal-title":"Cureus"},{"key":"6209_CR17","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.13264","author":"S Dutta","year":"2021","unstructured":"Dutta S, Gaur NK, Reddy A et al (2021) Antegrade jejunojejunal intussusception: an unusual complication following feeding jejunostomy. Cureus. https:\/\/doi.org\/10.7759\/cureus.13264","journal-title":"Cureus"},{"key":"6209_CR18","doi-asserted-by":"publisher","DOI":"10.12890\/2022_003161","author":"J Komagamine","year":"2022","unstructured":"Komagamine J, Noritomi D (2022) Jejunal intussusception caused by a nasointestinal ileus tube. Eur J Case Rep Intern Med. https:\/\/doi.org\/10.12890\/2022_003161","journal-title":"Eur J Case Rep Intern Med"},{"key":"6209_CR19","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1177\/0148607113489832","volume":"38","author":"C Egnell","year":"2014","unstructured":"Egnell C, Eksborg S, Grahnquist L (2014) Jejunostomy enteral feeding in children: outcome and safety. J Parenter Enteral Nutr 38:631\u2013636. https:\/\/doi.org\/10.1177\/0148607113489832","journal-title":"J Parenter Enteral Nutr"},{"key":"6209_CR20","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.jss.2015.06.058","volume":"199","author":"I Campwala","year":"2015","unstructured":"Campwala I, Perrone E, Yanni G et al (2015) Complications of gastrojejunal feeding tubes in children. J Surg Res 199:67\u201371. https:\/\/doi.org\/10.1016\/j.jss.2015.06.058","journal-title":"J Surg Res"},{"key":"6209_CR21","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/S0022-3468(82)80336-9","volume":"17","author":"MP Oswald","year":"1982","unstructured":"Oswald MP, Graviss ER, Danis RK et al (1982) Duodenogastric intussusception causing gastric outlet obstruction. J Pediatr Surg 17:82\u201383. https:\/\/doi.org\/10.1016\/S0022-3468(82)80336-9","journal-title":"J Pediatr Surg"},{"key":"6209_CR22","doi-asserted-by":"publisher","unstructured":"Singh RR, Eaton S, Roebuck DJ et al (2018) Surgical jejunostomy and radiological gastro-jejunostomy tube feeding in children: risks, benefits and nutritional outcomes. Pediatr Surg Int 34:951\u2013956. https:\/\/doi.org\/10.1007\/s00383-018-4303-8","DOI":"10.1007\/s00383-018-4303-8"},{"key":"6209_CR23","doi-asserted-by":"publisher","unstructured":"Michaud L, Coopman S, Guimber D, Sfeir R, Turck D, Gottrand F (2012) Percutaneous gastrojejunostomy in children: efficacy and safety. Arch Dis Child 97(8):733-734. https:\/\/doi.org\/10.1136\/archdischild-2011-300653","DOI":"10.1136\/archdischild-2011-300653"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-025-06209-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00383-025-06209-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-025-06209-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T09:27:41Z","timestamp":1763630861000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00383-025-06209-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,2]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6209"],"URL":"https:\/\/doi.org\/10.1007\/s00383-025-06209-1","relation":{},"ISSN":["1437-9813"],"issn-type":[{"type":"electronic","value":"1437-9813"}],"subject":[],"published":{"date-parts":[[2025,10,2]]},"assertion":[{"value":"19 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"306"}}