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Complications associated with image-guided gastrostomy and gastrojejunostomy tubes in children Friedman JN; Ahmed S; Connolly B; Chait P; Mahant SPediatrics 2004[Aug]; 114 (2): 458-61OBJECTIVE: To evaluate the complications associated with the image-guided insertion of gastrostomy (G) and gastrojejunostomy (GJ) tubes in children, performed by the retrograde percutaneous route. METHODS: A convenience sample of 208 charts of 840 patients recorded as having G and/or GJ tubes placed by the interventional radiology service in a 4-year period (1995-1999) at the Hospital for Sick Children in Toronto, Canada, were selected for review. Complications were categorized as major (including subcutaneous abscess, peritonitis, septicemia, gastrointestinal bleeding, and death) or minor. RESULTS: In total, 253 tubes (208 G tubes, 41 GJ tubes, 4 G and GJ tubes) were placed in the 208 patients reviewed. The median age at the time of insertion was 15 months (range: 7 days-18 years). The most common diagnostic category was neurologic disease (47%). The main indications for tube insertion were recorded as failure to thrive (57%) and risk of aspiration (47%). Major complications were seen in 5% of patients. Peritonitis was noted in 3%, and there was 1 death related to tube insertion (0.4%). Minor complications were found in 73% of patients, including tube dislodgement (37%), tube leakage (25%), and G-tube site skin infection (25%). GJ tubes had a higher rate than G tubes of obstruction, migration, dislodgement, leakage, and intussusception. Site infection, gastroesophageal reflux, and bleeding from the site were seen less frequently in patients with GJ tubes compared with G tubes. CONCLUSION: G and GJ tubes placed by the image-guided retrograde percutaneous method are associated with a wide range of complications. The majority of these are minor and are predominantly related to tube maintenance, but major complications, including death, do occur.|Abscess/etiology[MESH]|Adolescent[MESH]|Child[MESH]|Child, Preschool[MESH]|Enteral Nutrition/*adverse effects/instrumentation/methods/mortality[MESH]|Fluoroscopy[MESH]|Gastrointestinal Hemorrhage/etiology[MESH]|Gastrostomy/*adverse effects/methods/mortality[MESH]|Humans[MESH]|Infant[MESH]|Infant, Newborn[MESH]|Intussusception/etiology[MESH]|Jejunostomy/*adverse effects/methods/mortality[MESH]|Medical Audit[MESH]|Peritonitis/etiology[MESH]|Retrospective Studies[MESH]|Sepsis/etiology[MESH]|Stomach/diagnostic imaging[MESH] |
