Purpose

Stable naso-ileal tube positioning has historically been challenging due to technical challenges and is accordingly rarely used in the research setting.

We describe a technique for fluoroscopic naso-ileal tube placement using a bespoke catheter developed for studies requiring sampling of ileal content. We will report the methodology and technical success of accurate, sustained tube positioning.

Material and methods

34 healthy adult volunteers were included as part of two randomised crossover studies requiring tube placement into the distal ileum for bowel content sampling, with tube position maintained over four days (institutional ethics approved).

A custom-made 400cm-long quadruple lumen catheter (Dentsleeve International Ltd. Ontario, Canada) was commissioned. This included: air channel, balloon inflation channel, radio-opaque marker, aspiration channel and tip weight. Using fluoroscopy and barium sulphate for mapping, balloon inflation facilitated spontaneous propulsion to the target site.

Technical success was defined as ileal tube placement, sustained over four days.

Results

Naso-ileal tube placement was successful in 30/34 cases (88%) and stable throughout the four-day study. Of the four failed cases, in two, the tube failed to advance satisfactorily. One was removed due to patient anxiety and one migrated proximally into the stomach.

Conclusion

We have successfully developed and trialled a novel technique for tube placement in a usually inaccessible part of the bowel using a custom catheter. The tube was placed reliably in the majority of cases. Our research required bowel content sampling during dietary manipulations, but also has potential utility for accurate regional drug delivery and in drug development.