- •What patients are at highest risk of complications from GT dislodgement?
- •Postoperative patients and those who require stoma dilation are more likely to have complications during emergent replacement.
- •What is the best way to confirm proper GT placement?
- •Contrast injection is the current standard of care.
- •Ultrasound is both a safe and highly specific confirmatory test when used to confirm gastrostomy placement.
Level of evidence
Abbreviations:GT (Gastrostomy tube), LOS (Length of stay), PED (Pediatric emergency department), PEM (Pediatric emergency medicine), POCUS (Point-of-care-ultrasound), US (Ultrasound)
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
- Case volume and revisits in children undergoing gastrostomy tube placement.J Pediatr Gastroenterol Nutr. 2017; 65: 232-236https://doi.org/10.1097/MPG.0000000000001523
- Gastrostomy tube-related complaints in the pediatric emergency department: identifying opportunities for improvement.Pediatr Emerg Care. 2009; 25: 728-732https://doi.org/10.1097/PEC.0b013e3181bec847
- Emergency department utilization following pediatric gastrostomy tube placement is driven by a small cohort of patients.J Pediatr Surg. 2020; https://doi.org/10.1016/j.jpedsurg.2020.07.016
- Emergency presentations for gastrostomy complications are similar in adults and children.J Pediatr Gastroenterol Nutr. 2021; 72: 141-143https://doi.org/10.1097/MPG.0000000000002920
- Emergency department visits and readmissions among children after gastrostomy tube placement.J Pediatr. 2016; 174 (-45 e2): 139https://doi.org/10.1016/j.jpeds.2016.03.032
- Resource utilization after gastrostomy tube placement: defining areas of improvement for future quality improvement projects.J Pediatr Surg. 2014; 49: 1598-1601https://doi.org/10.1016/j.jpedsurg.2014.06.015
- Postoperative complications in children undergoing gastrostomy tube placement.J Laparoendosc Adv Surg Tech A. 2010; 20: 781-785https://doi.org/10.1089/lap.2010.0191
- Gastrostomy tube replacement in a pediatric ED: frequency of complications and impact of confirmatory imaging.Am J Emerg Med. 2012; 30: 1501-1506https://doi.org/10.1016/j.ajem.2011.12.014
- Percutaneous feeding tube replacement in the ED-are confirmatory x-rays necessary?.Am J Emerg Med. 2009; 27: 519-524https://doi.org/10.1016/j.ajem.2008.04.005
- Replacement of dislodged gastrostomy tubes after stoma dilation in the pediatric emergency department.West J Emerg Med. 2017; 18: 770-774https://doi.org/10.5811/westjem.2017.3.31796
- Use of Point-of-care ultrasound to guide pediatric gastrostomy tube replacement in the emergency department.Pediatr Emerg Care. 2018; 34: 145-148https://doi.org/10.1097/PEC.0000000000001400
- Overuse of fluoroscopic gastrostomy studies in a children's hospital.J Surg Res. 2014; 190: 598-603https://doi.org/10.1016/j.jss.2014.05.010
- Displaced gastrostomy tube in the pediatric emergency department: implementing an evidence-based algorithm and quality improvement project.J Emerg Nurs. 2021; 47: 113-122https://doi.org/10.1016/j.jen.2020.09.007
- Ultrasound-guided gastrostomy tube placement: a case series.J Pediatr Surg. 2017; 52: 1210-1214https://doi.org/10.1016/j.jpedsurg.2017.03.061
- Ultrasound-guided percutaneous 'push-introducer' gastrostomy is a valuable method for accessing the gastrointestinal tract.Nutr Hosp. 2014; 29: 365-369https://doi.org/10.3305/nh.2014.29.2.7127
- Percutaneous sonographic gastrostomy: method, indications, and problems.Am J Gastroenterol. 1998; 93: 941-945https://doi.org/10.1111/j.1572-0241.1998.00283.x
- Percutaneous gastrostomy guided by ultrasound and fluoroscopy.Acta Radiol. 1995; 36: 159-162
- Ultrasound guidance in percutaneous gastrostomy and gastrojejunostomy.Can Assoc Radiol J. 1995; 46: 196-198
- Ultrasound can accurately guide gastrostomy tube replacement and confirm proper tube placement at the bedside.J Emerg Med. 2009; 36: 280-284https://doi.org/10.1016/j.jemermed.2007.11.064
- Point-of-care ultrasound for confirmation of gastrostomy tube replacement in the pediatric emergency department.Intern Emerg Med. 2020; 15: 1075-1079https://doi.org/10.1007/s11739-020-02294-3
☆I have no competing interests to report.