title: Radiologic peroral gastrostomy.
abstract: 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.
authors.affiliation: Department of Medical Imaging, University of Toronto, St. Michael's Hospital, Ontario, Canada.
authors.forename: J A
authors.initials: JA
authors.lastname: Clark
authors.forename: R A
authors.initials: RA
authors.lastname: Pugash
authors.forename: R R
authors.initials: RR
authors.lastname: Pantalone
mesh_terms: D004750:Enteral Nutrition / Q000379:methods; D005471:Fluoroscopy; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D015641:Radiography, Interventional