EN
TÜRKÇE
Poster - 23
DISLODGED GASTROSTOMY TUBE: DAGNOSTIC CHALLENGES AND DIFFERENT THOUGHTS
M Elifranji, A Zarroug
Sidra Medicine, Qatar
Gastrostomy tube insertion is a common procedure to get an enteral feeding access in paediatric age group. It can be done via variety of techniques surgically, radiologically and endoscopically. However, Laparoscopic gastrostomy tube placement has gained popularity in many centres.
Dislodgement of Gastrostomy tube is a well-known complication. Early dislodgement after insertion can be associated with harm to patient up to and including death.
Diagnosis most of the time is challenging and get delayed. High index of suspicion in addition to good radiology imaging study are required.
We are presenting a leaning case of a baby who had a symptomatic dislodgement of the balloon- gastrostomy in few days after a successful laparoscopic gastrostomy tube placement for long term enteral feeding support.
Contrast study thru the gastrostomy tube showed a contained cavity filled with contrast with gastrostomy balloon inside which was misinterpreted as normal stomach with intact gastrostomy tube and no intra peritoneal leak. The cavity was due to the temporary percutaneous stay sutures that was holding the stomach to abdominal wall (figure1).
Figure 1: Contrast thru gastrostomy tube
The dislodgment of Gastrostomy tube was picked up via contrast study thru nasogastric tube (NG )in addition to Ultrasound to abdominal wall.
Figure2(A & B): Contrast study thru NG tube showed no balloon of Gastrostomy tube inside the stomach . And contrast can be seen in dudenum(B).
Figure 3: Ultrasound Abdomen confirmed that the ballooned Gastrostomy tube is extra luminal and there is subcutaneous fluid contrast.