A paitent met an accident with a car and has been in `deep coma' for the last 15 days. The most suitable route for the administration of protein and calories is by
Jejunostomy tube feeding
Gagstrotomy tube feeding
Nasogastric tube feeding
Central venous hyperalimentation
Unless the gastrointestinal tract is non-functional, its use for nutritional suppo is preferable to the use of either the central or a peripheral venous route. However, in a patient who is comatose either nasogastric feeding or feedings through a gastrostomy tube may lead to vomiting and aspiration. This problem can be avoided by using a nasoenteric tube with the tip placed in the jejunum under fluoroscopic or endoscopic control. Alternatively, a catheter may be placed directly into the proximal jejunum through a small upper abdominal incision
General surgery