Non-endoscopic percutaneous gastrostomy placement in children with recessive dystrophic epidermolysis bullosa

Title

Non-endoscopic percutaneous gastrostomy placement in children with recessive dystrophic epidermolysis bullosa

Creator

Stehr W; Farrell M K; Lucky A W; Johnson N D; Racadio J M; Azizkhan R G

Publisher

Pediatric Surgery International

Date

2008

Subject

Pediatrics; Surgery; anesthesia; epidermolysis bullosa; management; dilation; esophageal strictures; "Push"; chile; gastrostomy; iind international-symposium; non-endoscopic percutaneous gastrostomy; nutrition; santiago; feeding difficulties; surgical intervention; non-endoscopic percutaneous gastrostomy; gastrostomy tube placement

Description

Recessive dystrophic epidermolysis bullosa (RDEB) is associated with high nutritional demands, esophageal strictures and dysphagia. About one quarter of the patients require gastrostomy tube placement to maintain adequate nutritional status. To minimize trauma to the skin and pharyngoesophageal mucosa caused by commonly used gastrostomy tube insertion techniques, we used a non-endoscopic, percutaneous, image-guided approach. This approach combines the use of ultrasound for mapping of the liver and spleen, water-soluble contrast enema to visualize the colon, and gastric insufflation to define the stomach. The gastrostomy tube is replaced by a low-profile button gastrostomy tube 10-12 weeks postoperatively. The five female patients reported in this series ranged in age from 6 to 9 years. They all tolerated the procedure well and no perioperative complications were encountered. All were able to tolerate feedings on postoperative day 1 and all underwent successful replacement of gastrostomy tubes by low-profile button tubes. Our experience suggests that a non-endoscopic, image-guided approach to gastrostomy tube placement offers a safe, effective, and minimally traumatic alternative to more commonly used approaches. It minimizes the risk of procedure-related morbidity and leads to overall improvement in the quality of life. As such, we strongly recommend that it be included in the treatment armamentarium for patients with epidermolysis bullosa and nutritional failure.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation

Stehr W; Farrell M K; Lucky A W; Johnson N D; Racadio J M; Azizkhan R G, “Non-endoscopic percutaneous gastrostomy placement in children with recessive dystrophic epidermolysis bullosa,” Pediatric Palliative Care Library, accessed September 21, 2021, https://pedpalascnetlibrary.omeka.net/items/show/16819.

Social Bookmarking