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Percutaneous gastrostomy and percutaneous gastrojejunostomy in children: antegrade approach
R B Towbin1, W S Ball, G S Bissett
1Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229-2889.
Insights
Percutaneous gastrostomy and gastrojejunostomy are safe and effective for pediatric enteric alimentation. The antegrade approach is particularly suitable for children requiring long-term nutritional support.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Interventional Radiology
Background:
- Percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic gastrojejunostomy (PEJ) are established methods for enteral feeding.
- Application in the pediatric population requires careful consideration of safety and efficacy.
Purpose of the Study:
- To evaluate the safety and applicability of percutaneous gastrostomy (PG) and percutaneous gastrojejunostomy (PGJ) in pediatric patients.
- To describe an antegrade approach for PG and PGJ placement in children.
Main Methods:
- Twenty-five PGs and nine PGJs were performed in 24 pediatric patients (4 months to 22 years).
- Procedures utilized local anesthesia and sedation with an antegrade technique.
- Indications included central nervous system injury, malignancy, failure to thrive, and other conditions.
Main Results:
- No major complications were reported; only three minor skin infections occurred.
- The antegrade approach was successfully employed for all placements.
- Patients were managed by a nutritional support team post-procedure.
Conclusions:
- Percutaneous gastrostomy and gastrojejunostomy are safe and effective for pediatric enteric alimentation.
- The antegrade approach is a viable option for nutritional support in children of all ages.
- These procedures offer a reliable solution for long-term feeding in pediatric patients.
Abstract:
Twenty-five percutaneous gastrostomies and nine percutaneous gastrojejunostomies were performed in 24 children aged 4 months to 22 years. Indications for percutaneous gastrostomy included severe injury to the central nervous system (nine patients), malignancy (seven patients), failure to thrive (four patients), degenerative central nervous system disease (one patient), and miscellaneous conditions (three patients). All procedures were performed under local anesthesia and sedation. An antegrade approach is described for percutaneous gastrostomy and percutaneous gastrojejunostomy placement. No major complication occurred, and only three skin infections have been encountered. The children were evaluated and followed up by a nutritional support team. Early experience with percutaneous gastrostomy and percutaneous gastrojejunostomy in the pediatric population suggests that the technique is safe and applicable to children of all ages and sizes. In particular, the antegrade approach appears to be an acceptable solution for enteric alimentation.