Peritonitis following percutaneous gastrostomy tube insertions in children

Dookhoo, Leema; Mahant, Sanjay; Parra, Dimitri A.; John, Philip; Amaral, João; Connolly, Bairbre

doi:10.1007/s00247-016-3628-5

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…Different population characteristics might be an explanation for these different results. In the majority of children, a neurological disorder is the reason for PEG placement (21)(22)(23)(24)29,32,(34)(35)(36)(37)(38), whereas in adults, malignancies and diabetes mellitus are the main reasons for PEG placement. Immunosuppression and higher age make adults more prone to infection (27,28).…”

Section: Discussionmentioning

confidence: 99%

Do Antibiotics Reduce the Incidence of Infections After Percutaneous Endoscopic Gastrostomy Placement in Children?

Krom¹,

Hoek

Benninga³

et al. 2020

J. pediatr. gastroenterol. nutr.

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Objective: Percutaneous endoscopic gastrostomy (PEG) provides a long-term solution for tube dependency. Pediatric guidelines recommend prophylactic antibiotic treatment (ABT) based on adult studies. Aim: To compare wound infection and other complications in children receiving a PEG with and without prophylactic ABT. Methods: Retrospective study including children 0 to 18 years undergoing PEG placement. Patients with (2010–2013) and without (2000–2010) ABT were compared with respect to the occurrence of wound infection and other complications. Results: In total, 297 patients were included (median age 2.9 years, 53% boys). Patients receiving ABT per PEG protocol (n = 78) had a similar wound infection rate (17.9% vs 21%, P = 0.625), significantly less fever (3.8% vs 14.6%, P = 0.013), leakage (0% vs 9.1%, P = 0.003) and shorter hospital admission (2 vs 4 days, P = 0.000), but more overgranulation (28.2% vs 8.7%, P = 0.000) compared with those without (n = 219). Patients receiving any ABT, per PEG protocol or clinical indication (n = 115), had similar occurrence of wound infection (19.1% vs 20.9%, P = 0.768), fever (7.8% vs 14.3%, P = 0.100) and leakage (3.5% vs 8.8%, P = 0.096), a significantly shorter hospital admission (3 vs 4 days, P = 0.000), but more overgranulation (21.7% vs 8.8%, P =0.003) compared with those without (n = 182). Conclusions: Prophylactic ABT does not seem to reduce the occurrence of wound infection but it might be beneficial with respect to fever, leakage and duration of hospital admission, but not overgranulation. A randomized controlled trial is needed to confirm our results.

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Section: Discussionmentioning

confidence: 99%

Do Antibiotics Reduce the Incidence of Infections After Percutaneous Endoscopic Gastrostomy Placement in Children?

Krom¹,

Hoek

Benninga³

et al. 2020

J. pediatr. gastroenterol. nutr.

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“…Interruption of the healing gastrostomy could result in tract dehiscence with the potential for intraperitoneal leakage and subsequent peritonitis (69) . The tract should be well established after 12 weeks and BD can be used safely from then ( 28,70 ).…”

Section: Risks Of Bdmentioning

confidence: 99%

The Use of Blended Diets in Children With Enteral Feeding Tubes

Köglmeier¹,

Assecaira²,

Banci

et al. 2022

J. pediatr. gastroenterol. nutr.

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Objectives: This joint position paper of the Committees of Allied Health Professionals (CAHP) and Nutrition (CON) of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) provides a comprehensive guide for health professionals to manage blended diets in children via gastrostomy tubes. Methods: A systematic literature search was performed from 1992 to 2021 using Pubmed, MEDLINE, and Cochrane Database of Systematic Reviews and recent guidelines reviewed. In the absence of evidence, recommendations reflect the authors’ expert opinion. Final consensus was obtained by multiple e-mail exchange and virtual meetings of the CAHP and CON. Results: Reported benefits of blended diets include reduced GERD and infections, improved defecation, level of alertness and attention span, skin conditions, and appearance of hair and nails. Families report a sense of greater normality. Small case series, cross-sectional surveys, questionnaire-based small case studies, reports of personal experience, and single-center pilot studies are available in the medical literature. A total of 20 recommendations for practice were made based on the results and consensus process. Conclusions: There is little evidence published to formally inform about the potential health benefits or risks of this practice and how to use it in the best way. This leaves health professionals caring for such patients in a relative vacuum regarding what to consider when providing a duty of care to patients and carers who wish to pursue this method of feeding. This article provides guidelines for safe and appropriate use of a BD, but more research is needed.

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“…Retrograde pigtail catheter placements, conversely, may be performed with mild-to-moderate sedation. 17,31 Subsequent exchanges and conversion to a low-profile "button" usually do not require sedation. This benefit must be weighed against the higher infection and dislodgement rates.…”

Section: Comparison Of Techniquesmentioning

confidence: 99%

Image-Guided Enteral Access and Interventions in Children

Reis

2019

Dig Dis Interv

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A variety of image-guided therapies exist for children who cannot maintain adequate nutrition due to underlying pathologies that affect their enteric systems. Gastrostomy, gastrojejunostomy, and cecostomy tubes can be inserted to help address these issues using ultrasound, fluoroscopic, and computed tomography (CT) guidance. This article describes radiological techniques used to place these tubes.

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Peritonitis following percutaneous gastrostomy tube insertions in children

Cited by 8 publications

References 19 publications

Do Antibiotics Reduce the Incidence of Infections After Percutaneous Endoscopic Gastrostomy Placement in Children?

Do Antibiotics Reduce the Incidence of Infections After Percutaneous Endoscopic Gastrostomy Placement in Children?

The Use of Blended Diets in Children With Enteral Feeding Tubes

Image-Guided Enteral Access and Interventions in Children

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