Radiologic peroral gastrostomy.
OBJECTIVE
To develop an improved percutaneous technique for the insertion of large-bore gastrostomy tubes.


METHODS
With use of fluoroscopic guidance, the stomach is punctured and the esophagus is catheterized in a retrograde fashion. A guide wire is passed from the gastrostomy site, up the esophagus, and out of the patient's mouth. A large-bore (20-24 F) endoscopic push-type gastrostomy tube is advanced over the wire, through the mouth, down the esophagus, and out of the gastrostomy site.


RESULTS
Thirty-one successful tube placements were performed in 32 attempts (97% success rate). There were no major procedural or postprocedure complications. Minor complications included one lip laceration (one of 31 = 3%), one minor exit site infection (one of 31 = 3%), and two inadvertent tube dislodgements (two of 31 = 6%).


CONCLUSIONS
Radiologic placement of large-bore endoscopic gastrostomy tubes is possible without endoscopy. The procedure is rapid, easy to perform, and safe.
Clark
J A
JA
Department of Medical Imaging, University of Toronto, St. Michael's Hospital, Ontario, Canada.
Pugash
R A
RA
Pantalone
R R
RR
D004750:Enteral Nutrition / Q000379:methods; D005471:Fluoroscopy; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D015641:Radiography, Interventional