Spontaneous transpyloric migration of a ballooned nasojejunal tube: a randomized controlled trial

JPEN J Parenter Enteral Nutr. 2000 Jul-Aug;24(4):240-3. doi: 10.1177/0148607100024004240.


Background: Spontaneous transpyloric migration of a simple nasojejunal tube (NJT) can be expected in only one-third of insertions. Guidance of the tube by radiologic or endoscopic maneuvers is usually required. We believed that locating a 5-mL balloon near the tip of an NJT on which natural peristalsis could act would improve the rate of spontaneous transpyloric migration and facilitate small bowel propagation.

Methods: Thirty healthy volunteers were randomly assigned to have an inflated or noninflated, ballooned NJT fashioned from a modified 9F Hickman line catheter inserted. The pH of aspirates was measured hourly and the final location of the tube assessed by gastrografin contrast abdominal x-ray (AXR) at the end of 6 hours, at which time the tube was removed.

Results: After 6 hours, spontaneous transpyloric migration occurred in 86.6% of the ballooned and 66.6% of the nonballooned tubes. The final disposition of the ballooned tubes was: stomach, 2 (13.3%); duodenum, 1 (6.7%); and small bowel, 12 (80%). The final disposition of the nonballooned tubes was: stomach, 5 (33%), NS; duodenum, 9 (60%), p < .05; and small bowel, 1 (6.7%), p < .05.

Conclusions: Ballooned NJT have a higher rate of spontaneous transpyloric migration and are significantly more likely to achieve an optimal small bowel location.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Endoscopy, Gastrointestinal
  • Enteral Nutrition / instrumentation
  • Enteral Nutrition / methods*
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Intubation, Gastrointestinal / adverse effects
  • Intubation, Gastrointestinal / instrumentation*
  • Intubation, Gastrointestinal / methods
  • Male
  • Middle Aged
  • Pylorus
  • Time Factors