[How to make sure a balloon-type gastrostomy replacement was made right by ultrasound]

With the spread of gastric fistula, there have been increased reports of catheter aberrant and fistula damage during the time of catheter exchange procedures. Therefore, it has been recommended that a diagnostic imaging or endoscopic gastrostomy should be employed to make sure a catheter exchange was properly done. However, it is difficult to enforce an inspection using an X-ray or endoscopy in the home care environment. Here we examined the usefulness and problems associated with ultrasound catheter-validation for home care environment. Of 33 patients who received gastrostomy, we focused on 6 patients who had gastrostomy exchanged at home. Four out of 6 patients with a balloon-type gastrostomy exchanged clearly confirmed a good result by ultra sound. However, a patient with bumper-type was unclear. The reason being unclear was due to the material and shape of the appearance by the echo. Left costal arch operations approach is to scan the probe along the left side of the abdomen below the costal arch, so that a replaced gastrostomy catheter could be confirmed by following the low echoic area of the spleen, stomach vault and into the stomach cavity. It is considered that ultrasound examination of the exchanged balloon-type gastrostomy was useful under a consideration of patient's health conditions.