What special requirement is needed when replacing/placing jejunostomy tubes?

• A. Radiographic verification with contrast medium
• B. Endoscopic verification
• C. Ultrasound guidance
• D. Clinical assessment only

Answer: (A)

When a jejunostomy tube is placed or replaced, you must confirm that the tube actually lies inside the jejunal lumen before starting feeds. The most reliable way to do this is radiographic verification with contrast. By injecting contrast through the tube and taking an X-ray, you can visualize the tube’s course and ensure the tip is in the jejunum rather than in the stomach or outside the bowel. This step is crucial to prevent serious complications such as peritoneal leakage, infection, or feeds reaching the wrong site, which could lead to ineffective nutrition or aspiration.

Endoscopic verification is an alternative method some centers may use, but radiographic confirmation is the standard requirement in many practice settings. Ultrasound guidance may assist during placement, but it does not reliably confirm intraluminal position for feeding. Relying on clinical assessment alone cannot ensure correct tube placement.