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September 1952

MAYDL JEJUNOSTOMY: Technical and Metabolic Considerations

Author Affiliations

From the Departments of Surgery and Nutrition, State University of Iowa College of Medicine, and the Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, N. C.

AMA Arch Surg. 1952;65(3):367-372. doi:10.1001/archsurg.1952.01260020381004

IN SPITE of a more aggressive approach in the treatment of malignant disease of the upper intestinal tract that has come about during the past few years, there still remains a large group of unfortunate people on whom even palliative extirpation of their lesions cannot be safely performed. We still encounter, therefore, as a result of obstruction, pain, or persistent fistulae, situations in which for a considerable length of time feeding through an artificial stoma must be utilized.

Our experience with permanent gastrostomy at such times has not been too rewarding. In spite of the many techniques available, sooner or later most gastrostomy stomas leak or develop an unpleasant odor. The frequency of feeding becomes a nuisance, not only to the patient but to his entire household. This has led us to reexplore the efficacy of jejunal feedings when such feedings are required.

Of the four principal varieties of jejunostomy