- Patient preparation: none
- Contrast used: barium or high osmolar water soluble, dilute contrast using 2 parts contrast : 1 part sodium chloride if < 1 year old or 1 part tap water if > 1 year old, determine volume to be given by asking parent the volume of an average feed in ccs over how many hours
- Technique:
— Scout image
— Place the patient in a right lateral position
— Slowly inject the contrast through the G-tube making sure to fill the patient’s stomach to its physiologic capacity by giving the patient’s feed volume slowly over 10-15 minutes in the right lateral position to facilitate gastric emptying
— Follow contrast head through small bowel looking for level of obstruction
— Once contrast visibly stops moving forward revert to overhead images every 30 minutes until contrast reaches colon - Images to obtain: lateral image of the tube tract and the tube in the stomach, AP image of the tube in the stomach, AP images of abdomen, spot images with compression as needed
- Looking for: tube balloon causing gastric outlet obstruction, gastroesophageal reflux, slow bowel motility, small bowel narrowing or strictures, obstruction
- Post procedure tasks: flush gastrostomy tube with sterile saline, if barium used advise patient to drink plenty of liquids to wash barium out of system and that barium will lighten color of stools
Pediatric Imaging 