Routine gastrostomy tube placement in children: Does preoperative screening upper gastrointestinal contrast study alter the operative plan?

Journal of Pediatric Surgery
Paulette I AbbasAshwin P Pimpalwar

Abstract

Upper GI (UGI) studies are routinely ordered to screen for malrotation before routine placement of gastrostomy (G) tubes. However, the usefulness of this study is unknown. A retrospective review of children with surgically placed G-tubes over a 2 year period (2011-2013) was performed. Patients with concomitant fundoplications were excluded. Three hundred ninety-three patients underwent G-tube placement. Of these, 299 patients (76%) had preoperative UGI, and 11 patients (3.7%) were identified with malrotation on UGI. Five (1.7%) patients underwent a Ladd's procedure. The remaining 6 either had malrotation associated with gastroschisis (n=5) or were lost to follow-up (n=1). Children <1 year did not have different rates of malrotation compared to older children (4.3% vs. 3.2%, p=0.617). Likewise, children with neurologic impairment (NI) had similar rates of malrotation compared to neurologically normal (NN) children (2.6% vs. 3.8%, p=0.692). The only significant difference in malrotation rate was between those with congenital gastrointestinal anomalies (24%) and those without (1.5%) (p<0.001). Preoperative screening UGI before routine G-tube placement led to an unexpected diagnosis of malrotation in only 1.7%. Given the added radi...Continue Reading

References

Jul 14, 2010·Journal of Pediatric Surgery·Begum AkayGeorge B Mychaliska
Jul 14, 2010·Journal of Pediatric Surgery·Patricia A ValusekGeorge W Holcomb
May 6, 2014·Journal of Pediatric Gastroenterology and Nutrition·Catherine M Larson-NathPraveen S Goday

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Citations

Jun 23, 2021·Journal of Pediatric Gastroenterology and Nutrition·Matjaž HomanJorge Amil-Dias

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