Percutaneous gastrostomy in patients with complete obstruction of the upper digestive tract

Gastrostomy for nutritional support can be performed radiologically when endoscopic technique is not possible. In patients with complete obstruction of the upper digestive tract, the radiological technique in its conventional method may not be possible, as insertion of naso-gastric tube for gastric...

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Bibliographic Details
Published in:European journal of radiology 2005-10, Vol.56 (1), p.74-77
Main Authors: Quadri, A., Umapathy, N., Orme, R.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Female
Gastrostomy
Gastrostomy - adverse effects
Gastrostomy - methods
Humans
Intestinal Obstruction - surgery
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Nutritional Support - methods
Percutaneous
Punctures - methods
Radiological gastrostomy
Retrospective Studies
Stomach - diagnostic imaging
Stomach - surgery
Treatment Outcome
Ultrasonography
Ultrasound
Upper Gastrointestinal Tract - diagnostic imaging
Upper Gastrointestinal Tract - surgery
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Summary:Gastrostomy for nutritional support can be performed radiologically when endoscopic technique is not possible. In patients with complete obstruction of the upper digestive tract, the radiological technique in its conventional method may not be possible, as insertion of naso-gastric tube for gastric insufflation is not always successful. We reviewed our experience of gastrostomy insertion in nine such patients after failure of the conventional method. In seven of the nine patients, initial gastric puncture was achieved with a 22G needle under direct ultrasound visualisation. In the remaining two patients, initial puncture was made into locules of gas in the stomach with fluoroscopy. The stomach was then distended with air and a gastrostomy tube inserted by conventional technique. We conclude that percutaneous gastrostomy can be undertaken safely even in the presence of complete obstruction of the upper digestive tract and recommend this technique in this selective group of patients.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2005.03.030