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Radiological evaluation following placement of gastrostomy tube

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Determine the type of gastrostomy tube from clinician/parent and establish the time since insertion.

Photographs of gastrostomy tubes are included under "Gastrostomy" in the Starship Clinical Guidelines.

If gastrostomy is mature, being used for feedings and there is no concern regarding its function, the gastrostomy tube can be used for injection of barium as part of an upper gastrointestinal study and/or small bowel follow through examination. After injection of barium, the tube should be flushed with water.

If insertion occurred within the prior 6 weeks or if no gastrostomy feedings have been given, consider the gastrostomy track as immature.

For clinical concern regarding possible leak, infection around abdominal wound, malposition, use water soluble, non-ionic contrast material eg Omnipaque 300.

  • Review prior studies of the abdomen if available.
  • Have the assistance of a nurse if possible. Make sure a connection tube is available.
  • Assess position of tube tip in AP and lateral projections before introducing contrast.
  • Inject a small amount of air through the tube. Injection of an air bolus should immediately distend the stomach if the tip is intra-luminal. Blockage of tube causes resistance to injection of air.
  • Inject full strength water soluble contrast media slowly. Assess and document the integrity of the tube, and position of the tip of the tube, in both AP and lateral projections.
  • The lateral projection is usually more revealing of an extra-gastric position of tube, leak,  or fistulas.
  • Convey results of examination to referring clinician.

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  • Date last published: 28 October 2017
  • Document type: Imaging Protocol
  • Services responsible: Paediatric Radiology

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