Fig. 1. A 56-year-old female with prior sleeve gastrectomy in need of enteral feeding. (A) After air insufflation of jejunum through a 5-Fr catheter introduced through the nostril, fluoroscopic image demonstrates puncture of a loop of proximal jejunum with a T-fastener needle with injection of iodinated contrast confirming appropriate puncture. (B) Insertion of guidewire through the needle after deployment of one T-fastener. (C) Insertion of a 4-Fr vascular sheath, through which additional T-fasteners were deployed. (D) Final image after insertion of the 12-Fr balloon-retained jejunostomy tube shows good contrast opacification of the bowel without evidence of extraluminal contrast.
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