Pediatric Percutaneous Gastrostomy Tube

We begin planning our approach by doing an ultrasound study of your child’s abdomen, which will help us identify the track to the stomach and the location of vital structures (such as other organs and blood vessels) to be avoided during the procedure. Then, we place a small tube through the nose into the stomach and fill the stomach with air. This makes the stomach an easier, more visible target for puncture with a needle from the skin. Once we have marked a spot for the feeding tube, we will inject a local numbing medicine into the skin. The interventional radiologist will use live X-ray (fluoroscopy) to place a needle through the skin into the stomach. After the needle is in the stomach, the hole will be dilated (made bigger) and the gastrostomy tube will be inserted over a guide wire. Your child's doctor will inject contrast during X-rays to ensure the tube is in the stomach. 

No. Your child will either received IV sedation or general anesthesia.

Your child will not feel pain during the procedure. Your child may feel discomfort around the tube for a few days following the procedure. We will give your child pain medicine to alleviate the tenderness.

The procedure usually takes one hour. It may take a little longer depending on your child anatomy.

Gastrostomy tube placements are considered low risk procedures. However, potential complications include:

• Tenderness or soreness at the site where the tube is placed
• Bleeding
• Infection
• Injury to the other organs, such as the liver, spleen and colon, which may require additional surgery to repair
• Peritonitis, a serious condition in which the lining of the abdominal cavity becomes inflamed
• Loss of access to the stoma (stomach opening).

Your child will be admitted to Children's National Hospital for an overnight stay. We will give your child pain medicine as needed and monitor for infection or complications. We will assess (feel, touch and listen to) your child’s abdomen the day following tube placement. If there are no post-procedure symptoms, we will clear the tube for use, and your child will be allowed to eat and drink the following day. Tube feeds may also be started.

The G-tube site will be covered with a dressing. The site and the dressing need to be cleaned and changed daily. There will be two to three T-fasteners on your child’s abdomen. These look like small buttons and hold the tube in place and allow the tract to heal. We will remove the T-fasteners at an appointment 7-10 days after the placement if they have not already fallen off on their own. 
We will either schedule a follow-up appointment with our team, or we will come see your child at an already scheduled appointment with their primary team. 

Your child may take a sponge bath 48 hours after the procedure. It is very important that the area around the tube is not submerged in water for two weeks.

You will learn how to take care of the tube (both clean around it and how to flush the tube) before your child leaves the hospital. Your child’s primary team will teach you how to administer feeds, how to troubleshoot and how to use the feeding pump (if applicable).

There are no specific activity restrictions. However, your child shouldn't participate in contact sports or rough playing that might pull the tube.

After two to three months the primary tube may be removed and changed to a low-profile button which sits 1 to 2 centimeters off the skin, or another type of tube which hangs out approximately 6 inches. Your referring physician will decide which type of tube is best for your child.