Limitations and uses of gastrojejunal feeding tubes

Godbole, Prasad; Margabanthu, Gomathi; Crabbe, David; Thomas, Adrian G; Puntis, John; Abel, Gill; Arthur, Rosemary; Stringer, Mark D.

doi:10.1136/adc.86.2.134

Cited by 75 publications

(73 citation statements)

References 16 publications

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“…Duodenogastric reflux may occur because of a short jejunal tube, intestinal dysmotility, or distal obstruction [6,9,14,17]. Use of prokinetic agents and a longer length of the jejunal tube may help in such situations, after distal obstruction has been excluded.…”

Section: Duodenogastric Refluxmentioning

confidence: 97%

“…When gastric feeding is either not tolerated or is contraindicated, enteral feeding may be useful. Use of a gastrojejunal (GJ) feeding tube was first described about 4 years after PEG [3,4] and has been reported to be successful in adults and children [5][6][7][8][9][10][11][12], in whom it is increasingly used. One of the main indications for use of GJ tube feeding is to prevent aspiration, particularly in neurologically impaired children, in whom it is reported to be as effective as fundoplication for this purpose [13••, 14-16].…”

Section: Introductionmentioning

confidence: 99%

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Frequency and Methods of Gastrojejunal Tube Replacement in Children

Shah

Klooster

Yanni

et al. 2010

Curr Gastroenterol Rep

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Gastrojejunal (GJ) tubes are increasingly used for enteral feeding in children in whom gastric feeding either is not tolerated or is contraindicated. The most common complications associated with GJ tube use are mechanical failure (clogging, cracking, deterioration) and dislodgement. Less common, but more significant, complications are bowel perforation, aspiration, and feeding intolerance. Some of these complications may be prevented by replacing GJ tubes at regular intervals. Methods to direct a GJ tube include 1) guidewire, 2) gastroduodenoscopy-guidewire, 3) esophagogastroduodenoscopy-forceps, and 4) fluoroscopy-guidewire. Clinical experience to determine the ideal method and optimal timing of GJ tube replacement is evolving. GJ tube replacement using a guidewire through the prior GJ tube, without endoscopy, fluoroscopy, or sedation, is the least risky method, but is also the least likely to be successful.

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Section: Duodenogastric Refluxmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Frequency and Methods of Gastrojejunal Tube Replacement in Children

Shah

Klooster

Yanni

et al. 2010

Curr Gastroenterol Rep

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show abstract

“…In these cases, overt obstructive features and significant intestinal distention were not present. [8]…”

Section: Discussionmentioning

confidence: 99%

Limited Utility of Plain Abdominal Radiographs in Evaluating Intussusceptions Secondary to Long Indwelling Feeding Tubes

Yang

Lall

Bhargava

et al. 2013

Journal of Clinical Imaging Science

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Adult intussusception (AI) is relatively rare and can be a difficult clinical diagnosis, often requiring cross-sectional imaging for confirmation. Unfortunately, intussusceptions in the setting of indwelling long enteral feeding tubes have been predominantly characterized in the pediatric population with minimal investigation in adults. We report three cases of AI in patients with long feeding catheters serving as anatomic lead points leading to intussusception diagnosed on cross-sectional imaging. We highlight the limited utility of the supine plain films for detection of AI, and it behooves the radiologist to hold a high index of suspicion if the patient has a long enteral catheter. Since the majority of these patients tend to be fairly ill and unable to stand for upright abdominal radiographs, in the setting of percutaneous feeding tubes, decubitus abdominal radiographs should always be obtained. These cases also highlight the importance of having a high clinical suspicion of intussusceptions in a patient presenting with abdominal pain in the setting of an enteral feeding tube. In post-operative patients, other factors can predispose the patient to intussusception, including adhesions. Another interesting feature in tube related AI is the reverse intussusception that may be seen with indwelling enteral tubes. Reverse intussusception is where the distal bowel telescopes into the proximal segment over the tube.

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“…que seja considerada, atualmente, como uma alternativa eficaz para alimentação entérica de longo prazo. [44][45][46] No que respeita à colocação de uma jejunostomia percutânea sob controlo endoscópico, a experiência atual em crianças é muito limitada. 47,48 A realização de uma jejunostomia cirúr-gica, nomeadamente se assistida por laparoscopia, é uma técnica eficaz e minimamente invasiva que deve assim ser considerada precocemente.…”

Section: Fontes De Financiamentounclassified

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

Estevão‐Costa

2014

Acta Med Port

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RESUMOO aporte nutricional adequado é crucial na abordagem terapêutica de múltiplos estados mórbidos, o que justifica o recurso frequente e crescente a vias de acesso específicas para nutrição entérica e parentérica. No presente artigo é realizada uma revisão da literatura relevante acerca de indicações, modalidades, eficácia e complicações das vias de acesso entérico na criança. Os fatores a considerar na decisão entre acesso gástrico e acesso pós-pilórico, e entre colocação de sonda nasogástrica e gastrostomia são criteriosamente discutidos. Perante indicação para acesso gástrico de longa duração, a gastrostomia endoscópica percutânea é a técnica mais utilizada dada a sua eficácia e segurança, embora a morbilidade associada não seja desprezível; a colocação de gastrostomia laparoscópica emerge como uma alternativa potencialmente vantajosa. Palavras-chave: Criança; Nutrição Entérica; Intubação Gastrointestinal; Gastrostomia; Jejunostomia; Laparoscopia. ABSTRACTAppropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications of enteral access routes in children. The decision between gastric and postpyloric access, and between nasogastric tube and gastrostomy is thoroughly discussed. Percutaneous endoscopic gastrostomy is the most commonly used technique when a long-term gastric access is required, given its efficacy and safety although the associated morbidity is not negligible; laparoscopic gastrostomy emerges as a potentially advantageous alternative.

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Limitations and uses of gastrojejunal feeding tubes

Cited by 75 publications

References 16 publications

Frequency and Methods of Gastrojejunal Tube Replacement in Children

Frequency and Methods of Gastrojejunal Tube Replacement in Children

Limited Utility of Plain Abdominal Radiographs in Evaluating Intussusceptions Secondary to Long Indwelling Feeding Tubes

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

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