COMPLICATIONS FOLLOWING PERCUTANEOUS ENDOSCOPIC GASTROSTOMY AND SUBSEQUENT CATHETER REPLACEMENT IN CHILDREN AND YOUNG-ADULTS

Background: Percutaneous endoscopic gastrostomy has gained wide accept ance for patients who require prolonged tube feeding support, We sough t to identify complications and associated risk factors of endoscopic gastrostomy and subsequent catheter replacement in pediatric patients. Methods: Medical records were reviewed for 137 patients, Odds ratios were calculated for complications related to patient age, weight, weig ht-for-age Z score, and principal diagnosis. Results: Seventeen patien ts (12.4%) developed significant complications after gastrostomy: cell ulitis occurred in 10 patients (7.3%); other complications included ga strocolic fistula (2), duodenal hematoma (1), complicated pneumoperito neum (1), necrotizing fasciitis (1), gastric perforation (1), and cath eter migration (1). Patients with cancer had significantly greater odd s for developing a wound infection, and patients with AIDS had signifi cantly greater odds for total complications. A trend toward increased wound infection was observed in patients with cardiac disease. Age, we ight, and weight-for-age Z score were not associated with adverse outc ome. Two complications occurred in 85 patients (2.4%) after gastrostom y catheter replacement. Conclusions: Pediatric patients with cancer an d AIDS are at increased risk for complications after endoscopic gastro stomy regardless of age, weight, or nutritional status. Infrequent yet life-threatening complications may occur after replacement of initial gastrostomy catheter.