| Autor: |
Tomiyasu K; Department of Neurology, Saiseikai Utsunomiya Hospital., Oshima T; Department of Neurology, Saiseikai Utsunomiya Hospital., Yoshii M; Department of Neurology, Saiseikai Utsunomiya Hospital., Ichikawa T; Department of Neurology, Saiseikai Utsunomiya Hospital., Inamasu J; Department of Neurosurgery, Saiseikai Utsunomiya Hospital., Kimata M; Department of Surgery, Saiseikai Utsunomiya Hospital. |
| Jazyk: |
japonština |
| Zdroj: |
Rinsho shinkeigaku = Clinical neurology [Rinsho Shinkeigaku] 2022 Apr 27; Vol. 62 (4), pp. 298-300. Date of Electronic Publication: 2022 Mar 29. |
| DOI: |
10.5692/clinicalneurol.cn-001692 |
| Abstrakt: |
A 68-year-old woman with Parkinson's disease, who had previously undergone Roux-en-Y gastrojejunostomy for early gastric cancer, complained of wearing-off and troublesome dyskinesia that had progressed over 7-years. After the introduction of levodopa-carbidopa intestinal gel therapy (LCIG) by nasojejunal tube, she had a good clinical response. Percutaneous endoscopic gastrostomy with a jejunal extension tube was difficult in this case, due to lack of gastrostomy site and fibrous postoperative adhesion. We introduced LCIG by direct percutaneous endoscopic jejunostomy (D-PEJ) which offers a less invasive procedure to operative tube placement. The factors affecting the success of D-PEJ could interfere with transillumination, abdominal thickness and the location of other organs. We determined the optimum site of catheter insertion with the assistance of real-time 3D reconstruction CT-jejunography. She was discharged home on postoperative day 14 without any procedure-related complications. Real-time 3D reconstructive CT-jejunography guided D-PEJ is a useful method for a patient who benefit from LCIG with prior gastrojejunostomy. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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