[Solved]: LOCATION: Outpatient, Hospital PATIENT: Ernest…

LOCATION: Outpatient, Hospital PATIENT: Ernest Grande PRIMARY PHYSICIAN: Alma Naraquist, M.D. INTERVENTIONAL RADIOLOGIST: Edward Riddle, M.D. CLINICAL SYMPTOMS: Abdominal pain and malnutrition PROCEDURE: Attempted placement of gastrojejunostomy catheter HISTORY: The patient is a 79-year-old man with a history that includes abdominal pain and malnutrition. Dr. Naraquist has requested the placement of a gastrojejunostomy catheter. Before start of the study, the procedure was explained to the patient, including the risks, complications, and alternatives. The patient understood and consented to the procedure. DESCRIPTION OF PROCEDURE: The patient was prepped and draped in the usual sterile fashion. The patient was also sedated. The gastrojejunostomy catheter could not be safely placed percutaneously because of the patient’s anatomy. There is marked dilatation of what is thought to represent small bowel, which is displacing the stomach superiorly. If distension of the small bowel is relieved, percutaneous placement may be possible at a later date. IMPRESSION: Percutaneous gastrojejunostomy catheter could not be placed because of the patient’s anatomy, as described above.