Which condition can lead to a need for PEJ placement?

Functional gastric outlet obstruction is a condition that can lead to the need for percutaneous endoscopic jejunostomy (PEJ) placement. This condition results when there is a functional impairment of the stomach that prevents normal gastric emptying, which may occur without any physical obstruction. Patients suffering from functional gastric outlet obstruction often experience severe nausea, vomiting, and inadequate nutrition due to the inability to adequately digest and absorb food.

In such cases, a PEJ can provide a means for nutritional support directly into the jejunum, bypassing the affected stomach area to help maintain adequate nutrition and hydration. This is particularly crucial in cases where oral intake is impossible or inadequate for an extended period.

In contrast, while ulcerative colitis can lead to various complications that may require nutritional support, it does not typically lead directly to the need for a PEJ. High blood pressure and gallstones are unrelated to the need for PEJ placement, as they do not directly impact the gastrointestinal tract's functional ability to process food. Therefore, functional gastric outlet obstruction is clearly the condition most directly associated with PEJ placement due to the associated challenges with gastric emptying and nutrition.