Open AccessHow replace the gastrostomy tube in children with extremely compromised general conditions
Author(s) -
C. Noviello,
Marcedes Romano,
Lorenzo Rossi,
Giovanni Cobellis,
Ascanio Martino
Publication year - 2019
Publication title -
african journal of paediatric surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.163
H-Index - 17
eISSN - 0189-6725
pISSN - 0974-5998
DOI - 10.4103/ajps.ajps_100_17
Subject(s) - medicine , gastrostomy tube , gastrostomy , general anaesthesia , enteral administration , percutaneous endoscopic gastrostomy , surgery , parenteral nutrition , general surgery , anesthesia , finance , peg ratio , economics
The percutaneous endoscopic gastrostomy is the best technique to use in case of children requiring long-time enteral nutrition. The first replacement of the tube is easy in most of the patient, but this step can be extremely problematic in patients with compromised general conditions. The authors report their experience in some cases. Two boys with endoscopic gastrostomy had a deterioration in the general conditions, when replacing the probe, these conditions contraindicated anaesthesia for which the "cut-and-push" technique was adopted in a patient with heart malformation and a local anaesthetic in a neuropathic patient. Both the boys died a few days after this procedure. In our opinion, in children who are not using anaesthesia to reposition the gastrostomy probe, it is best to continue feeding through the nasogastric probe.