Insertion of a Primary Gastrostomy Device in Children

The insertion of a primary gastrostomy device in children is a medical procedure used to create an opening in the stomach for direct access, typically for feeding or administering medications. This procedure is often necessary for children who have difficulty swallowing, have certain neurological conditions, or require long-term nutritional support.

Indications

• Difficulty swallowing (dysphagia) due to neurological disorders such as cerebral palsy
• Failure to thrive due to inadequate oral intake
• Need for long-term enteral nutrition support
• Certain gastrointestinal conditions that prevent normal feeding

Preparation

Before the procedure, the child will typically undergo:

• Complete medical history and physical examination
• Imaging studies (e.g., ultrasound or CT scan) to evaluate the stomach's position and rule out any potential complications
• Blood tests to assess overall health and coagulation status
• Fasting for a specified period before the procedure, as determined by the healthcare provider
• Administration of antibiotics as prophylaxis against infection, if recommended

Procedure

The insertion of a primary gastrostomy device can be performed using different techniques, including:

• Percutaneous Endoscopic Gastrostomy (PEG): This involves the use of an endoscope to visualize the stomach and guide the placement of the gastrostomy tube through the abdominal wall.
• Surgical Gastrostomy: This is an open surgical procedure where the gastrostomy tube is placed directly into the stomach under general anesthesia.
• Laparoscopic Gastrostomy: A minimally invasive technique using a laparoscope to assist in placing the gastrostomy tube.

Post-Procedure Care

After the procedure, the child will be monitored for complications and will receive instructions on:

• Care of the gastrostomy site to prevent infection
• Use and maintenance of the gastrostomy device
• Feeding schedules and nutritional management
• Recognition of potential complications, such as leakage, blockage, or infection, and when to seek medical help

Potential Complications

Possible complications include:

• Infection at the gastrostomy site
• Leakage around the tube
• Gastrointestinal bleeding
• Blockage or dislodgement of the tube
• Nutritional deficiencies if feedings are not properly managed

Follow-Up Care

Regular follow-up appointments with the healthcare provider are crucial to monitor the child's nutritional status, adjust feeding regimens as necessary, and address any complications or concerns related to the gastrostomy device.