EXPERIENCE WITH GASTROJEJUNAL FEEDING TUBES IN CHILDREN

Objective: Assessment of untoward symptomatic outcomes and major/minor complications occurring in children with percutaneous gastrojejunal t ubes (GJT) in place. Methods: A retrospective chart review of 28 patie nts with GJTs was performed. The diagnoses for these patients were: ne urological diseases, 23; respiratory diseases, two; and gastrointestin al tract disorders, three. Twenty-three tubes were placed radiological ly, four endoscopically, and one surgically. Patients' age range was b etween 1.5 and 180 months (mean 47.2 months), and weight at the time o f tube insertion was between 2.28 and 42.7 kg. (mean 11.7 kg.). Durati on of follow-up was from 1 to 49 months (mean 17.3 months). The patien ts were evaluated for the persistence or new development of the follow ing symptoms: vomiting, hematemesis, abdominal pain, constipation, dia rrhea, pain at the site of gastrostomy tube insertion, strider with fe eds, and dumping. Minor complications (including breakage, partial/tot al displacement, or dislodgement of GJT, tube occlusion, tube leakage, transient infection and/or granuloma at the gastrostomy site, and con tinued gastroesophageal reflux post-GJT conversion), as well as major complications (requiring surgical intervention) and mortality, were as sessed. Results: One or more symptoms either persisted or developed de novo in 20 children after tube insertion. Vomiting was the most commo n symptom, being present in 16 patients. One or more minor complicatio n occurred in 21 patients; the most common was the accidental dislodge ment of the jejunal feeding catheter. Major complications occurred in 11 patients (e.g., fundoplication in seven patients). Five patients di ed. Six patients had no complications; at the time of GJT placement, t heir mean age (93.3 months) was significantly older (p = 0.0269) and m ean weight (21.3 kg.) significantly heavier (p = 0.0067) than those of children reporting major complications. Conclusions: We conclude that ongoing or new gastrointestinal symptoms and minor complications are common in children with GJT. However, GJT placement in larger children is associated with fewer complications than in smaller children.