Successful Colonoscopic Retrieval of a Migrated Feeding Jejunostomy Tube: A Minimally Invasive Approach

Case Presentation A 56-year-old woman with advanced, unresectable esophageal squamous cell carcinoma (ECOG Performance Status 3), previously palliated with a surgically placed feeding jejunostomy (FJ) 3-month back, presented with acute abdominal pain and the reported loss of the external FJ tube (although the patient had taken feed one day back prior to presentation). Physical examination revealed a patent stoma on the abdominal wall without evidence of cellulitis or peritonitis. Initial plain abdominal radiography ([ Fig. 1 ]) identified a coiled, radio-opaque tubular structure in the right lower quadrant, concerning for intraluminal migration. A subsequent noncontrast CT was done in emergency itself ([ Fig. 2 ]) confirmed the presence of the entire FJ catheter within the cecum and ascending colon. Notably, there was no evidence of bowel wall edema, pneumoperitoneum, or mechanical obstruction. Given the patient's frailty and the distal location of the tube, a minimally invasive endoscopic approach was prioritized. Colonoscopy identified the coiled FJ tube residing freely within the ascending colon ([ Fig. 3 ]). The catheter was secured using rat-tooth forceps and successfully retrieved transanally under direct visualization ([ Fig. 4 ]). The procedure was well-tolerated without mucosal injury or postprocedural complications. The patient remained asymptomatic and was discharged the following day. A subsequent esophagogastroduodenoscopy confirmed a high-grade malignant stricture at 28 cm, necessitating the placement of a new FJ to restore enteral access. Fig. 1 Abdominal X-ray image showing migrated feeding jejunostomy tube in large bowel (yellow arrow). Fig. 2 Computed tomography image showing impacted feeding jejunostomy tube in colonic lumen (yellow arrow head). Fig. 3 Colonoscopic image showing feeding jejunostomy tube anchored with rat tooth forceps in ascending colon. Fig. 4 Image showing the retrieved feeding jejunostomy tube. This case underscores the necessity of a structured diagnostic-therapeutic algorithm. Radiological evaluation with CT is indispensable for excluding “red-flag” features such as perforation or bowel ischemia before attempting endoscopy. In the absence of such complications, colonoscopic retrieval is a safe, effective, and superior alternative to surgery, particularly in patients with advanced malignancy and poor performance status. Authors' Contributions All authors contributed equally to the preparation of this article. Informed Consent Patient provided informed consent to publish the included information. Publication History Article published online: 13 June 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical and Scientific Publishers Private Limited A-13A, Graphix Tower 1, 6th floor, Sector 62, Noida 201309, Uttar Pradesh, India