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

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