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Gastric prolapse through a gastrostomy tract

Tracey A Janik1, Richard J Hendrickson, Joseph S Janik

  • 1Division of Surgery, Department of Pediatric Surgery, University of Colorado Health Sciences Center, Denver, CO, USA.

Journal of Pediatric Surgery
|June 24, 2004
PubMed

Insights

Gastric prolapse through a gastrostomy tract affects 1.2% of children, particularly those with ventilator dependence, poor nutrition, or neurologic disorders. Certain gastrostomy devices and techniques increase prolapse risk.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Devices

Background:

  • Gastric prolapse through a gastrostomy tract is a rare complication in children.
  • Limited data exists on its incidence and associated risk factors.

Purpose of the Study:

  • To determine the incidence of gastric prolapse in children with gastrostomy tubes.
  • To identify patient and device characteristics associated with gastric prolapse.

Main Methods:

  • Retrospective review of 1,042 pediatric patients with gastrostomy construction between 1992 and 2002.
  • Analysis of 14 parameters to identify correlations with gastric prolapse incidence.

Main Results:

  • Gastric prolapse occurred in 1.2% of children (13/1,042), with recurrent prolapse in 0.5% (5/1,042).
  • Risk factors included ventilator dependence (31%), poor nutrition (54%), and neurologic disorders (58%).
  • Gastrostomy devices with both ends fixed and rigid (2.7%) and laparoscopic gastrostomy techniques were associated with higher prolapse rates.

Conclusions:

  • Children with poor nutrition, ventilator dependence, or neurologic disorders are prone to gastric prolapse.
  • Fixed, rigid gastrostomy devices and laparoscopic techniques are associated with increased risk.
Abstract

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