A Technical Guide to Enteral Access and Complications

Enteral nutrition is essential for those unable to maintain adequate caloric intake orally. Access to the gastrointestinal tract is necessary to deliver enteral nutrition. Many options for enteral access are available, raising questions in clinical practice regarding what type and timing of access is required.

Short-term enteral nutrition may be provided by nasogastric or nasoenteric access. Long-term enteral nutrition may require a percutaneous endoscopic gastrostomy or radiographic percutaneous gastrostomy. If long-term enteral nutrition is required and the stomach is not functional, jejunal access may be used, consisting of a percutaneous endoscopic gastrostomy with jejunal extension, direct percutaneous endoscopic jejunostomy, or surgical jejunostomy. Despite technique utilized, complications do exist. Early recognition and treatment of these complications are essential for patient outcomes and preservation of enteral access.

This review addresses the different types of enteral access, including details on the indications, procedures, and complications so that providers may have better understanding and utilization.