Which enteral feeding access device will deliver nutrition past the ligament of Treitz?

Which enteral feeding access device will deliver nutrition past the ligament of Treitz?

• A. Nasogastric
• B. Nasoduodenal
• C. Percutaneous gastrostomy
• D. Percutaneous jejunostomy

Answer: (D)

Delivering nutrition past the ligament of Treitz requires access to the jejunum, since that ligament marks the duodenojejunal flexure where the small intestine transitions from the duodenum to the jejunum. A feeding tube that ends in the stomach or proximal duodenum cannot reach beyond this point. The percutaneous jejunostomy provides direct access into the jejunum, bypassing the stomach and duodenum, so nutrition is delivered distal to the flexure. In contrast, a nasogastric tube delivers to the stomach, a nasoduodenal tube to the duodenum before the flexure, and a percutaneous gastrostomy to the stomach.

Delivering nutrition past the ligament of Treitz requires access to the jejunum, since that ligament marks the duodenojejunal flexure where the small intestine transitions from the duodenum to the jejunum. A feeding tube that ends in the stomach or proximal duodenum cannot reach beyond this point. The percutaneous jejunostomy provides direct access into the jejunum, bypassing the stomach and duodenum, so nutrition is delivered distal to the flexure. In contrast, a nasogastric tube delivers to the stomach, a nasoduodenal tube to the duodenum before the flexure, and a percutaneous gastrostomy to the stomach.