title: Frequency and methods of gastrojejunal tube replacement in children.
abstract: Gastrojejunal (GJ) tubes are increasingly used for enteral feeding in children in whom gastric feeding either is not tolerated or is contraindicated. The most common complications associated with GJ tube use are mechanical failure (clogging, cracking, deterioration) and dislodgement. Less common, but more significant, complications are bowel perforation, aspiration, and feeding intolerance. Some of these complications may be prevented by replacing GJ tubes at regular intervals. Methods to direct a GJ tube include 1) guidewire, 2) gastroduodenoscopy-guidewire, 3) esophagogastroduodenoscopy-forceps, and 4) fluoroscopy-guidewire. Clinical experience to determine the ideal method and optimal timing of GJ tube replacement is evolving. GJ tube replacement using a guidewire through the prior GJ tube, without endoscopy, fluoroscopy, or sedation, is the least risky method, but is also the least likely to be successful.
authors.affiliation: Pediatric Gastroenterology, Loma Linda University, 11175 Campus Street, Coleman Pavilion, Loma Linda, CA, 92350, USA. mshah@llu.edu
authors.forename: Manoj
authors.initials: M
authors.lastname: Shah
authors.forename: Marquelle
authors.initials: M
authors.lastname: Klooster
authors.forename: George
authors.initials: G
authors.lastname: Yanni
authors.forename: Amul
authors.initials: A
authors.lastname: Shah
mesh_terms: D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000379:methods*; D004750:Enteral Nutrition / Q000295:instrumentation* / Q000379:methods; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D007223:Infant