Experience with gastrojejunal feeding tubes in children. 1997

J M Peters, and P Simpson, and V Tolia
Children's Hospital of Michigan, Department of Pediatrics, Wayne State University, Detroit, USA.

OBJECTIVE Assessment of untoward symptomatic outcomes and major/minor complications occurring in children with percutaneous gastrojejunal tubes (GJT) in place. METHODS A retrospective chart review of 28 patients with GJTs was performed. The diagnoses for these patients were: neurological diseases, 23; respiratory diseases, two; and gastrointestinal tract disorders, three. Twenty-three tubes were placed radiologically, four endoscopically, and one surgically. Patients' age range was between 1.5 and 180 months (mean 47.2 months), and weight at the time of tube insertion was between 2.28 and 42.7 kg. (mean 11.7 kg.). Duration of follow-up was from 1 to 49 months (mean 17.3 months). The patients were evaluated for the persistence or new development of the following symptoms: vomiting, hematemesis, abdominal pain, constipation, diarrhea, pain at the site of gastrostomy tube insertion, stridor with feeds, and dumping. Minor complications (including breakage, partial/total displacement, or dislodgement of GJT, tube occlusion, tube leakage, transient infection and/or granuloma at the gastrostomy site, and continued gastroesophageal reflux post-GJT conversion), as well as major complications (requiring surgical intervention) and mortality, were assessed. RESULTS One or more symptoms either persisted or developed de novo in 20 children after tube insertion. Vomiting was the most common symptom, being present in 16 patients. One or more minor complication occurred in 21 patients; the most common was the accidental dislodgement of the jejunal feeding catheter. Major complications occurred in 11 patients (e.g., fundoplication in seven patients). Five patients died. Six patients had no complications; at the time of GJT placement, their mean age (93.3 months) was significantly older (p = 0.0269) and mean weight (21.3 kg.) significantly heavier (p = 0.0067) than those of children reporting major complications. CONCLUSIONS We conclude that ongoing or new gastrointestinal symptoms and minor complications are common in children with GJT. However, GJT placement in larger children is associated with fewer complications than in smaller children.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007441 Intubation, Gastrointestinal The insertion of a tube into the stomach, intestines, or other portion of the gastrointestinal tract to allow for the passage of food products, etc. Intubation, Nasogastric,Gastrointestinal Intubation,Gastrointestinal Intubations,Intubations, Gastrointestinal,Intubations, Nasogastric,Nasogastric Intubation,Nasogastric Intubations
D008297 Male Males
D009422 Nervous System Diseases Diseases of the central and peripheral nervous system. This includes disorders of the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscle. Neurologic Disorders,Nervous System Disorders,Neurological Disorders,Disease, Nervous System,Diseases, Nervous System,Disorder, Nervous System,Disorder, Neurologic,Disorder, Neurological,Disorders, Nervous System,Disorders, Neurologic,Disorders, Neurological,Nervous System Disease,Nervous System Disorder,Neurologic Disorder,Neurological Disorder
D010146 Pain An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS. Suffering, Physical,Ache,Pain, Burning,Pain, Crushing,Pain, Migratory,Pain, Radiating,Pain, Splitting,Aches,Burning Pain,Burning Pains,Crushing Pain,Crushing Pains,Migratory Pain,Migratory Pains,Pains, Burning,Pains, Crushing,Pains, Migratory,Pains, Radiating,Pains, Splitting,Physical Suffering,Physical Sufferings,Radiating Pain,Radiating Pains,Splitting Pain,Splitting Pains,Sufferings, Physical
D012135 Respiratory Sounds Noises, normal and abnormal, heard on auscultation over any part of the RESPIRATORY TRACT. Breathing Sounds,Crackles,Lung Sounds,Pleural Rub,Rales,Rhonchi,Stridor,Wheezing,Breathing Sound,Crackle,Lung Sound,Pleural Rubs,Rale,Respiratory Sound,Rhonchus,Rub, Pleural,Sound, Breathing,Sound, Lung,Sound, Respiratory,Sounds, Breathing,Sounds, Lung,Stridors,Wheezings
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003248 Constipation Infrequent or difficult evacuation of FECES. These symptoms are associated with a variety of causes, including low DIETARY FIBER intake, emotional or nervous disturbances, systemic and structural disorders, drug-induced aggravation, and infections. Colonic Inertia,Dyschezia

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