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Cecostomy tube

Patients who have trouble passing along fecal content can use a cecostomy tube to administer an enema to help push along the intestinal material through the anus. The tube is a plastic passageway placed into the first part of the large intestine, through the skin in the lower part of the right abdomen. You will be properly trained about enema administration and tube maintenance before the procedure is performed.

About this Treatment

About this Treatment

How do we perform a cecostomy tube insertion?

Before the procedure, the patient must follow a “bowel prep” to cleanse the colon, which is an essential step for successful placement of the tube. The doctor begins the procedure by inflating the colon with air until the cecum is distended. The doctor inserts a small needle through the skin into the cecum, and then attaches the bowel to the abdominal wall with two stitches. A catheter is then threaded through a special hollow needle into the cecum. To confirm proper placement of the catheter, we will inject contrast dye through the catheter, using live X-ray (fluoroscopy) to make sure the dye travels into the cecum. Your child will be protected by an X-ray shield during the procedure.

Will my child be awake for the procedure?

No. We will use either IV sedation or general anesthesia so that your child isn’t awake.

Will my child be in any pain?

Your child will not feel pain during the procedure but some patients may feel discomfort around the tube insertion site for a few days following the procedure.

How long does the procedure take?

A typical cecostomy tube insertion takes about an hour but may take longer. Some children may need to arrive may hours before the procedure to have certain lab tests performed, which will be clearly communicated to you.

What are the risks of this procedure?

The procedure is considered low-risk. However, potential complications include:

  • Peritonitis (infection in the abdomen)
  • Abscess (infected fluid collection)
  • Bleeding
  • Injury to the colon and/or surrounding structures
  • Loss of access into the stoma (large intestine opening)
Pre and Post Operative Care

Pre and Post Operative Care

How do my child and I prepare for the procedure?

We encourage good communication between you and your child, including the necessity and overview of the procedure as well as ensuring them that you are close by the whole time. Holding them or their hands until they leave for the procedure is a great way to provide support.

You will be given specific instructions along the way but you may need to arrive a few hours before the scheduled procedure to have some blood tests done. When you arrive at the hospital, a doctor will review the procedure and associated risks, after which you will sign a consent form. When we are ready to get started with the procedure, a nurse will place an intravenous line to deliver sedating medications and you will be allowed to accompany your child in the operating room until they are asleep, after which you will be escorted to a waiting room.

What happens after the procedure?

Most children are hospitalized for two to three days to minimize the risk of complications. Your child will receive IV antibiotics while in the hospital, and we will give you a prescription for oral antibiotics at discharge. Your child will be allowed to move around as tolerated. The catheter insertion site may be tender for several days.

When may my child eat normally after the procedure?

A clear-liquid diet must be continued until normal bowel function returns, which may take several days.

What kind of enemas will my child be receiving and when can I start administrating them?

Your child’s doctor will talk about the proper bowel-cleansing regimen with you based on your child’s unique needs. Usually you can start administering enemas through the tube after approximately one week.

When can my child bathe?

You can allow your child to sponge bathe for the first 48 hours after the procedure. It is important to avoid full submersion in water for two weeks after the procedure to allow for healing around the tube insertion site.

Are there any activity restrictions?

Though your child can resume normal school-going or daycare attendance, physical activity that can result in pulling of the tube should be limited, particularly contact sports and rough playing.

Does the tube need to be changed and how long will the tube stay in place?

Yes. The tube will be removed two months after it is placed. It will be replaced with a low-profile tube, which sits on the surface of the skin. Routine changes of this tube will be performed once or twice a year. The total duration of tube placement will be determined by the physician caring for your child’s underlying disease but the primary tube will be exchanged at scheduled follow-ups. Specific concerns regarding clogging of the tube or the tube falling out will be addressed in your training prior to the procedure. These are not emergencies and can most often be handled by simple water flushing of the tube through a syringe or slightly pushing the tube back into place and securing it with tape while not feeding through it. It is important to call our department soon after these occurrences.


•     Redness, pain, swelling, or bruising at the needle insertion site.

•     Fever higher than 101o Fahrenheit or 38o Celsius.

The department of Interventional Radiology can be reached at: 202-476-3791, Monday through Friday, between 8 a.m. and 5 p.m.

At all other times please call 202-259-8643, which is the on-call pager. Follow the instructions and wait for a call back.

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