Gastrostomy-jejunostomy tube check

  • Patient preparation: none
  • Contrast used: low osmolar water soluble or barium, dilute contrast using 1 part contrast : 2 parts sodium chloride if < 1 year old or 2 parts tap water if > 1 year old
  • Technique:
    — Scout image
    — Place the patient in a supine position
    — Slowly inject contrast small amount of contrast (2 cc) through the jejunostomy tube to assess position of its tip and the integrity of the jejunostomy tube
    — Place the patient in a right lateral position
    — Slowly inject large amount of contrast (30 cc) through the gastrostomy tube to assess for patency of the bowel from the gastrostomy tube to the level of the jejunostomy tube tip and for intussusception caused by jejunostomy tube balloon
  • Images to obtain: lateral image of the gastrostomy tube tract and the gastrostomy tube in the stomach, AP image of the gastrostomy tube in the stomach, AP image of contrast between the gastrostomy tube and the jejunostomy tube, AP image of contrast beyond the jejunostomy tube
  • Looking for: gastrostomy tube tip not in stomach, gastrostomy tube balloon causing gastric outlet obstruction, gastroesophageal reflux, jejunostomy tube tip not in jejunum, jejunostomy tube tip balloon causing obstruction or small bowel-small bowel intussusception
  • Post procedure tasks: flush both ports with sterile saline