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Pediatric Gastrojejunostomy Tube Placement (GJ Tube)
A gastrojejunostomy tube placement (GJ tube) is just like a G-tube except that it contains an extra portion of tubing that extends from the stomach to the intestine. An extra side port allows feeding and medication delivery directly into the intestine through extension tubing. Your family will receive education on the skin care surrounding the tube site as well as on the proper usage and maintenance of the tube and extension material prior to the procedure.
If your child requires a GJ tube, typically a G-tube will be placed first, and then after six to eight weeks the tube can be converted from a G-tube to a GJ tube. However, on occasion a direct GJ tube will be placed. The Interventional Radiology team at Children's National Hospital will begin planning the 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. Your child's 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 GJ tube will be inserted over a guide wire into the intestine. The doctor will inject contrast during X-rays to ensure the end of the tube is in the intestine.
Your child's doctor will remove the G-tube, then measure the distance from outside the skin to inside the stomach. Then, a wire is used through the hole and guided while watching with live X-ray (fluoroscopy) into the stomach and then into the intestine. A GJ tube is placed over this wire, which is then removed. The GJ has a bumper to keep the tube in place.
Some children will be awake and we will use a local numbing medication during the GJ conversion. Depending on the age/development and size of the G-tube, your child may need IV sedation or general anesthesia.
Tube changes will occur every three months and do not require numbing medicine or sedation.
After the procedure, the site may be tender. You may give your child over-the-counter pain medicine.
The procedure is considered low risk. However, potential complications include:
- Bleeding from the skin (usually minimal)
- Infection of the surrounding skin of abdominal wall
- Bowel perforation with GJ tube placement (rare)
Learn about treatment
Interventional Radiology at Children's National Hospital
Our pediatric interventional radiologists perform a full range of minimally invasive, image-guided procedures to both diagnose and treat disease in infants, children and adolescents. Discover more about the treatment we offer.
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Children’s National interventional radiologists perform a full range of minimally invasive, image-guided procedures to both diagnose and treat disease in infants, children, and adolescents.