Further report of small-bowel intussusceptions related to gastrojejunostomy tubes

Background. The use of gastrojejunostomy (GJ) tubes for feeding pediatric p atients who have inadequate oral intake, cannot tolerate gastric feeding, o r have significant gastroesophageal reflux may present problems. Objective. To report our experience of intussusception associated with GJ t ubes, with emphasis on risk factors. Materials and methods. Clinical histories and imaging studies were reviewed for all patients with GJ tube-associated intussusceptions at our instituti on from January 1995 to March 1999. Results. Of 251 GJ tubes inserted, 40 (16 %) intussusceptions occurred in 3 0 patients (20 males). They ranged in age from 3 months to 17 years (mean 2 .6 years) and in weight from 3 to 90 kg (mean 12.5 kg). The underlying diag nosis varied. The main symptom was bilious vomiting. The initial diagnosis was made by sonography in 19 cases and fluoroscopy in 21. Intussusceptions recurred eight times in patients with a distal pigtail (n = 17) but only tw ice in patients without the distal pigtail (n = 18). Conclusions. GJ-tube related intussusception is a common, easily diagnosed problem. Predisposing factors appear to be male sex, young children, and pr esence of a distal pigtail on the tube. Awareness of intussusception is imp erative for prompt diagnosis to achieve feeding tolerance.