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Original Article
Website:
www.afrjpaedsurg.org
DOI:
10.4103/0189-6725.160353
PMID:
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Quick Response Code:
Ramazan Karabulut, Zafer Turkyilmaz, Kaan Sonmez, Suna Ozhan Oktar1, Cem Kaya,
Atilla Kokurcan1, Fatih Oncu1, Abdullah Can Basaklar
ABSTRACT
Background: Our aim is to share our experiences
regarding patients who cannot be fed effectively
through the gastrostomy tube, but were inserted feeding
jejunostomy through the gastrostomy orifice using scopic
fluoroscopic techniques utilised by the interventional
radiology. PatientsandMethods:Between January
2010 and May 2013 the patients that were inserted
jejunostomy tube through the gastrostomy orifice using
fluoroscopic techniques were retrospectively analysed.
Data including primary indication for gastrostomy,
sex, concomitant disease and the requirement for
gastroesophageal reflux disease (GERD) were all
recorded. Results: There were five patients with these
criteria. They all received either medical or surgical GERD
therapy; nevertheless enteral feeding failed to reach an
effective level, they all had vomiting and did not gain any
weight. Following conversion, all the patients gained
minimum 2 kg in 2-5months; all the patients tolerated
enteral feeding and were discharged in the early period.
There were neither procedure related complications
such as perforation, bleeding nor sedation related
complications. Procedure took no more than 30 min as
a whole. There was no need for surgical intervention.
However in one patient re-intervention was required due
to accidental removal of the catheter. Conclusions: In
case of feeding difficulties following the gastrostomy;
instead of an invasive surgical intervention; physicians
should consider jejunal feeding that is advanced through
the gastrostomy, which does not require any anaesthesia.
Key words: Gastrostomy, scopy, tube jejunostomy
INTRODUCTION
Gastrostomy is commonly used for feeding patients
with corrosive oesophageal burns, neurologic and
Departments of Pediatric Surgery and 1Radiology, Medical Faculty,
Gazi University, 06500 Besevler, Ankara, Turkey
Address for correspondence:
Prof. Ramazan Karabulut,
Gezegen Sokak No: 1/10, 06670 GOP ankaya, Ankara, Turkey.
E-mail: karabulutr@yahoo.com
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Karabulut, et al.: Jejunal tube advanced through the gastrostomy
RESULTS
DISCUSSION
Diagnosis
2 year/16 kg
2 months/3 kg
3 monhs/3.5 kg
6 months/5 kg
6 month/5 kg
Corrosive Esophagus
Classical esophageal atresia
Bochdalek hernia
Bochdalek hernia
Gastric volvulus
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Concommitant disease
GERD/Fundoplication
Removal time/weight
+/+
+/+
+/+/+/+
5 months/22kg
Continued 5 months/5.8 kg
Continued 4 months/6 kg
Continued 3 months/7 kg
Continued 2 months/6.5 kg
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Karabulut, et al.: Jejunal tube advanced through the gastrostomy
CONCLUSION
Jejunal feeding tubes fluoroscopically inserted through
the gastrostomy (PEG or open) seems to be a good
alternative to open revision or invasive procedure when
gastrostomy fails to provide effective enteral feeding
due to various reasons such as GERD, leakage, etc. This
procedure is not a surgical one, which makes it possible
to be applied by radiologist, paediatricians, etc. as well.
REFERENCES
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Cite this article as: Karabulut R, Turkyilmaz Z, Sonmez K, Oktar SO, Kaya C,
Kokurcan A, et al. A very feasible alternative in patients with feeding difficulties
from gastrostomy: Jejunal tube advanced through the gastrostomy. Afr J
Paediatr Surg 2015;12:119-21.
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