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Percutaneous nonendoscopic gastrostomy in children
D A Cory1, J F Fitzgerald, M D Cohen
1Department of Radiology, Riley Hospital for Children, Indiana University Medical Center, Indianapolis 46223.
Insights
Percutaneous gastrostomy is a safe and effective feeding tube placement for children. This method, guided by imaging, offers a viable alternative to surgical gastrostomy with minimal complications.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Surgical gastrostomy is a traditional method for pediatric nutritional support.
- Percutaneous endoscopic gastrostomy is emerging as a potentially safer, faster, and more cost-effective pediatric procedure.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous gastrostomy in infants and children.
- To compare percutaneous gastrostomy outcomes with previous surgical gastrostomy experiences.
Main Methods:
- 16 percutaneous gastrostomies were performed in 14 pediatric patients.
- All procedures utilized both sonographic and fluoroscopic guidance.
- Most procedures used parenteral sedation and local anesthesia; some used general anesthesia.
Main Results:
- Successful tube placement was achieved in all 16 procedures.
- No local infections, hemorrhage, or peritonitis were reported.
- Two patients experienced tube dislodgement requiring re-intervention; two had postprocedure septicemia responding to antibiotics.
Conclusions:
- Percutaneous nonendoscopic gastrostomy is a safe and effective procedure for pediatric patients.
- This technique provides a successful alternative for nutritional support in infants and children.
- The study highlights the benefits of image-guided percutaneous gastrostomy in a pediatric population.
Abstract:
Surgical gastrostomy has long been a standard method of providing nutrition to infants and children. Recently, percutaneous endoscopic gastrostomy has been advocated as a safer, quicker, less expensive method in children. We report our experience with 16 percutaneous gastrostomies in 14 infants and children; in all cases, both sonographic and fluoroscopic guidance were used. Four patients had had previous surgical gastrostomy in which the tubes could not be replaced once they were removed. The remaining patients were referred for percutaneous placement of gastrostomy tubes as the first procedure. In 13 procedures, parenteral sedation and local anesthesia were used; the remaining three procedures were done with the patient under general anesthesia. Tubes were successfully placed in all procedures. In two patients, tubes became dislodged, necessitating a second procedure. There were no instances of local infections, hemorrhage, or peritonitis, and none of the patients died. Two patients had postprocedure septicemia, which responded to antibiotics. Percutaneous nonendoscopic gastrostomy can be safely and effectively performed in infants and children.