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Fluoroscopically guided jejunal tube placement via percutaneous gastrostomy in children: technical success, safety,

Michael Esser1, Jakob Spogis2, Johannes Hilberath3

  • 1Department of Diagnostic and Interventional Radiology, Pediatric Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, Tübingen, 72076, Germany. michael.esser@med.uni-tuebingen.de.

Pediatric Radiology
|March 12, 2026
PubMed

Insights

Fluoroscopically guided percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) tube placement is safe and effective in children. This minimally invasive procedure offers high success rates with low radiation exposure for post-pyloric access.

Area of Science:

  • Pediatric Gastroenterology
  • Minimally Invasive Procedures
  • Interventional Radiology

Background:

  • Percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) offers minimally invasive post-pyloric access in children.
  • Limited data exist on the routine application and risks of fluoroscopically guided PEG-J placement.

Purpose of the Study:

  • To evaluate the safety and technical success of fluoroscopically guided PEG-J in pediatric patients.
  • Assess outcomes without the need for general anesthesia or sedation.

Main Methods:

  • Retrospective review of 126 PEG-J procedures in 60 pediatric patients (2011-2025).
  • Assessment of technical success, complications, anatomical variants, and tube patency.
  • Documentation of fluoroscopy time and dose area product (DAP).

Main Results:

  • Technical success rate was 85% (107/126), with jejunal or duodenal tip placement.
  • Nineteen procedures (15%) were unsuccessful, with 6 attributed to anatomical factors.
  • Median fluoroscopy time was 5 min 24 s, and median DAP was 6.1 cGy·cm².

Conclusions:

  • Fluoroscopically guided PEG-J placement is a safe and effective pediatric procedure.
  • The technique demonstrates high technical success.
  • Radiation exposure is low, supporting its routine use.
Abstract

Keywords:
Enteral nutritionGastric feeding tubesGastrostomyInterventional radiographyIntestinal diseasesPediatrics

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