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Comparison of gastrostomy tube replacement verification using air insufflation versus gastrograffin
David T Burke1, Amir El Shami, Edward Heinle
1Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA 02114, USA. dburke1@partners.org
Objective:
To compare the safety of air insufflation as a contrast medium for percutaneous endoscopic gastrostomy (PEG) tube replacement verification with that of the more traditional method using positive contrast material (gastrograffin) under fluoroscopic guidance.
Design:
Retrospective case series comparing 2 radiographic procedures used for PEG tube verification at a rehabilitation hospital. The first series reviewed studies of patients over 1 year, during which the method of choice for PEG tube replacement verification was with air insufflation. The second series reviewed studies of patients over the subsequent year, during which the method of choice for PEG tube replacement verification was with gastrograffin.
Setting:
An inpatient rehabilitation hospital.
Participants:
Nineteen patients and 29 PEG tube replacements were identified that used air insufflation and 17 patients and 19 PEG tube replacements were identified that used gastrograffin.
Interventions:
Not applicable.
Main Outcome Measures:
Medical complications in a 2-week follow-up period as a result of the verification procedures.
Results:
There were no cases in either of the replacement procedures in which the PEG tube was found to not be in the gastrointestinal system. There was also no evidence at 2-week follow-up that any of the patients' complications were the result of either procedure.
Conclusions:
The air contrast procedure appears to be a relatively safe alternative procedure for PEG tube replacement verification.
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