Pediatric gastrostomy tube check

  • Patient preparation: none
  • Contrast used: low osmolar water soluble if checking to see if newly placed / replaced gastric tube is in the stomach, barium for other indications, dilute contrast using 1 part contrast : 2 parts sodium chloride if 1 year old
  • Technique:
    — Scout image
    — Place the patient in a right lateral position
    — Slowly inject the contrast through the gastrostomy tube
  • Images to obtain: lateral image of the gastrostomy tube tract and the gastrostomy tube in the stomach, AP image of the tube in the stomach, to confirm positioning of gastrostomy tube ballon in stomach look for gastrostomy ballon to be surrounded by gastric rugae and contrast surrounding gastrostomy balloon on AP and lateral views
  • Looking for: gastrostomy tube tip not in stomach, migration of gastrostomy balloon into abdominal wall tract – if it is malplaced within abdominal wall tract contrast can still extend into stomach, gastrostomy tube balloon causing gastric outlet obstruction, gastroesophageal reflux
  • Post procedure tasks: flush gastrostomy tube with sterile saline