What is percutaneous gastrostomy?<\/span><\/strong><\/span> How is percutaneous gastrostomy done?<\/span><\/strong> Who needs percutaneous gastrostomy?<\/span><\/strong> What are the contraindications to percutaneous gastrostomy?<\/span><\/strong><\/span> How is gastrostomy tube cared for?<\/span><\/strong><\/span> How long can a gastrostomy tube be worn and how is it cared for?<\/span><\/strong><\/span> What is percutaneous gastrostomy? Per\u00a0is Latin for through. Cutaneous comes from cutis, Latin for skin. Gastro derives from gaster, Greek for stomach. Stomy is from stomatos, Greek for mouth. Thus, \u2018percutaneous gastrostomy\u2019 means making a hole (or opening\/mouth) in the stomach through the skin. It is the deliberate construction of a track from the skin […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,16,22],"tags":[],"class_list":["post-1147","post","type-post","status-publish","format-standard","hentry","category-about-ir-procedures-and-tests","category-gi-interventions","category-interventional-oncology-hello","pmpro-has-access"],"_links":{"self":[{"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/posts\/1147","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1147"}],"version-history":[{"count":8,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/posts\/1147\/revisions"}],"predecessor-version":[{"id":2742,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=\/wp\/v2\/posts\/1147\/revisions\/2742"}],"wp:attachment":[{"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1147"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1147"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.medradclinics.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1147"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nPer<\/em><\/strong>\u00a0is Latin for through. Cutaneous comes from cutis<\/em><\/strong>, Latin for skin. Gastro derives from gaster<\/em><\/strong>, Greek for stomach. Stomy is from stomatos<\/em><\/strong>, Greek for mouth. Thus, \u2018percutaneous gastrostomy\u2019 means making a hole (or opening\/mouth) in the stomach through the skin. It is the deliberate construction of a track from the skin to the stomach through which a feeding tube or catheter is inserted into the stomach to provide an access for nourishing a patient, bypassing the mouth and the esophagus.<\/span><\/p>\n
\nThe patient will have\u00a0nothing by mouth starting the midnight preceding the procedure. This empties the stomach, allowing a clean field and the use of sedation for the procedure. The patient is taken to the interventional radiology (IR) suit on the morning of the procedure and placed on a procedure table. A nurse or the physician sprays a local anesthetic at the back of the\u00a0patient’s\u00a0throat to numb it. Then a tube is passed through the\u00a0mouth into the stomach so it can be inflated with air. Sometimes this is done on the floor before the patient arrives the IR suite. The upper part of the abdomen and the lower chest are scrubbed with antiseptic lotion to prevent wound or blood infection. The patient\u00a0receives a prophylactic \u00a0intravenous antibiotic\u00a0and medications for conscious sedation. Then another intravenous medicine is given to\u00a0temporarily slow movements of the stomach and the\u00a0intestines and keep air in the stomach. The stomach is filled with air through the tube\u00a0in it and a small cut is made\u00a0on the anesthetized skin over the mid or lower stomach. A\u00a0needle is passed through the\u00a0skin incision into the stomach, through which\u00a02 or 3\u00a0T-shaped fasteners are deployed into the\u00a0stomach. These\u00a0fix the anterior wall\u00a0of the stomach against the posterior surface\u00a0of the anterior\u00a0abdominal wall and keep the stomach from slipping away during later maneuvers. A wire is passed\u00a0through the needle into the stomach and dilators are passed over the wire to dilate\u00a0the needle track. Then a\u00a0feeding tube is passed over the wire into the stomach and anchored to the skin. Finally,\u00a0iodinated radiocontrast is injected into the stomach through the tube to confirm that the tip of the tube is in the stomach and that there is no leakage around it.\u00a0A collecting bag\u00a0 is attached to the tube to collect air and liquid for 12 to 24 hours to make sure that all is well. The tube\u00a0may be used thereafter,\u00a0if all is well.<\/span><\/span><\/p>\n
\n1. Those who cannot\u00a0eat food by mouth for more than 30 days for any reason. <\/span>
\n2. Those whose\u00a0stomach has difficulty emptying itself. <\/span><\/span><\/p>\n
\nContraindications to percutaneous gastrostomy are conditions that\u00a0make the procedure\u00a0a hazard. They include the following:<\/span>
\n1. Uncorrectable coagulopathy. This means \u2018thinning\u2019 of the blood that predisposes to hemorrhage during or after the procedure.\u00a0<\/span>
\n 2. No safe access.\u00a0Scars from\u00a0past surgery or injury to the abdomen can distort the intra-abdominal anatomy.\u00a0 <\/span>
\n3. Gastric tumors.\u00a0Gastric cancer\u00a0can grow through the gastrostomy track\u00a0to the surface of the abdomen, if the track was unwittingly created close to or through the cancer. <\/span>
\n4. Abdominal varices. These are large collateral or bypass blood vessels on or in the abdomen that can be injured during gastrostomy.\u00a0They may occur in patients with cirrhosis of the liver or total obstruction of the inferior and superior vena cava.\u00a0<\/span>
\n5. Massive ascites. The abdomen is\u00a0full of liquid due to failure of the liver, the\u00a0kidneys or the heart; it is a relative contraindication, because the fluid can be emptied shortly before the procedure. <\/span>
\n6. Ventriculoperitoneal shunt. A small tube connects the ventricles in the brain with the peritoneal cavity in the abdomen.\u00a0The shunt\u00a0can become infected and the infection\u00a0spread up the tube into the brain; it, too, is\u00a0a relative contraindication. <\/span>
\n7. Severe gastroesophageal reflux. The cause\u00a0of heart burn. In this case the tip of your tube should be placed past the stomach to avoid inundating the stomach with liquid that may reflux into the esophagus.<\/span><\/p>\n
\nIt is easy to care for the tube at home. Just remember to flush it well after every use with water. Some recommend using any carbonated drink (any soda drink) to flush the tube because such drinks make lots of bubbles that help clear the tube. If\u00a0the tube\u00a0is used\u00a0to administer crushed tablets, they must be pulverized well before administration and the tube scrupulously irrigated after\u00a0 use. A clogged tube, if unsalvageable, should be replaced.<\/span><\/p>\n
\nA patient’s condition and their health-care provider’s\u00a0opinion\u00a0will decide when to stop using a gastrostomy tube. Removing\u00a0the tube\u00a0is easy.\u00a0This can be done by a home health care provider or\u00a0at the hospital.\u00a0Typically, the holes in the stomach and skin seal in 48 hours after removing the tube.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"