Sanchez R B, vanSonnenberg E, D'Agostino H B, Goodacre B W, Moyers P, Casola G
Department of Radiology, University of California, San Diego, Medical Center 92103.
Radiology. 1992 Jul;184(1):201-5. doi: 10.1148/radiology.184.1.1609080.
The authors describe the value of computed tomographic (CT) guidance for percutaneous gastrostomy (PG) or gastroenterostomy (PGE) in 22 patients with anatomic or pathologic difficulties precluding fluoroscopic guidance. Indications for PG or PGE were decompression for gastrointestinal obstruction (n = 15) or for feeding (n = 7). Thirteen patients previously underwent an unsuccessful attempt at or had been rejected as unsuitable for percutaneous endoscopic gastrostomy. CT guidance was selected because of inability to pass a nasogastric tube due to esophageal obstruction (n = 4), inability to tolerate gastric distention (n = 1), abnormal morphology in or around the stomach (n = 16), or simultaneous performance of a PG in one patient who was undergoing emergency CT-guided abscess drainage. Catheters were placed successfully in all 22 patients. No major complications occurred. CT is valuable for PG or PGE when anatomic or pathologic problems make fluoroscopic or endoscopic puncture unsafe or impossible.
作者描述了计算机断层扫描（CT）引导下经皮胃造口术（PG）或胃肠造口术（PGE）在22例因解剖或病理原因无法进行透视引导的患者中的应用价值。PG或PGE的适应证为胃肠道梗阻减压（n = 15）或喂养（n = 7）。13例患者此前经皮内镜胃造口术尝试失败或因不适合而被拒绝。选择CT引导是因为食管梗阻导致无法插入鼻胃管（n = 4）、无法耐受胃扩张（n = 1）、胃内或胃周围形态异常（n = 16），或1例正在接受急诊CT引导下脓肿引流的患者同时进行PG。所有22例患者均成功放置导管。未发生重大并发症。当解剖或病理问题使透视或内镜穿刺不安全或不可能时，CT对PG或PGE有重要价值。
