GASTROSTOMY BUTTON PLACEMENT THROUGH PERCUTANEOUS GASTROSTOMY TRACTS CREATED WITH FLUOROSCOPIC GUIDANCE - EXPERIENCE IN 27 CHILDREN

PURPOSE: The authors report their experience with skin level (button) gastrostomy placement through radiologically created gastrostomy tract s. PATIENTS AND METHODS: Fifty-two gastrostomy buttons have been place d in 27 children (average age, 73 months; range, 9-235 months), All bu ttons were placed through tracts created during earlier fluoroscopical ly guided percutaneous gastrostomy, Fifteen Bard mushroom-type buttons and 12 MIG-Key balloon-type buttons were initially placed, Patients h ave been followed up for an average of 13.4 months. RESULTS: Button pl acement was successful at the initial attempt in 25 of 27 patients (93 %), Tract age at button placement averaged 18.5 weeks, The average tra ct length measured 3.5 cm (1.7-6.0 cm), Tract rupture and peritoneal l eakage occurred in three patients; one patient had the button immediat ely repositioned without sequela, and the remaining two patients under went replacement of the gastrostomy tube into the stomach and successf ul button placement approximately 1 week later, There were no major co mplications, Minor problems (leak, granulation tissue, valve malfuncti on, balloon breakage) occurred in 19 patients.CONCLUSION: Button gastr ostomy is a useful alternative to the traditional gastrostomy tube for the pediatric population, Conversion with use of existing radiologica lly created tracts is possible and safe, Attention to tract integrity and proper button position is required to avoid complications.