NONENDOSCOPIC ANTEGRADE PERCUTANEOUS GASTROSTOMY - THE EFFECT OF PREPLACEMENT GASTRIC INSUFFLATION ON TUBE POSITION AND INTRAABDOMINAL ANATOMY

Nonendoscopic tube gastrostomy was performed on 47 anesthetized dogs u sing the technique of Fulton and Dennis(1) with or without gastric ins ufflation prior to tube placement. Immediately after tube placement, d ogs were euthanized and postmortem examinations performed. When gastri c insufflation was not performed (group I), gastrostomy tubes penetrat ed the visceral surface of the stomach in 25% of dogs. The deep leaf o f the omentum was interposed between stomach and body wall in the majo rity of these dogs, exposing other intra-abdominal organs to potential injury, Additionally, displacement and tethering of the spleen crania l to the gastrostomy site were observed in 33% of dogs in group I. Sim ilar results were obtained when preplacement gastric insufflation was performed after the orogastric tube was inserted sufficiently far to d isplace the stomach laterally against the body wall (group II). In con trast, consistent positioning of gastrostomy tubes through the parieta l surface of the stomach was achieved when the stomach was insufflated prior to lateralizing the left abdominal wall with the gastric end of the orogastric tube (group III). It was concluded that the blind perc utaneous gastrostomy technique is made safer by insufflating the stoma ch immediately prior to pushing the gastric wall laterally into contac t with parietal peritoneum. Copyright 1996 by the American College of Veterinary Internal Medicine.