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Gastrostomy

Percutaneous gastrostomy is a well-accepted, widely performed procedure in three main groups a

Fig. 3.23a,b. A misplaced gastrostomy catheter, with contrast agent spillage into the peritoneal cavity b a

Fig. 3.23a,b. A misplaced gastrostomy catheter, with contrast agent spillage into the peritoneal cavity of patients. The first group includes children with anatomic disorders of the proximal upper GI tract, including mouth, pharynx and esophagus, in which normal feeding is not possible. The second group consists of neurologically impaired children where normal swallowing is not possible or safe. The third group consists of patients who need more nutrition than normal feeding allows.

Imaging may be performed if a complication is suspected, such as duodenal obstruction by balloon, leakage around the gastrostomy tube, malposition of the gastrostomy tube (Fig. 3.23), gastrocolic and gastrojejunal fistula and duodenal hematoma. In most cases, water-soluble contrast agents or non-ionic low-osmolar contrast agents will be used, while barium should be used, if at all, with caution (van Rijn et al. 2006).

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