Nguyen Christian, Imani Reza A
Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA.
Radiol Case Rep. 2021 Apr 21;16(6):1586-1590. doi: 10.1016/j.radcr.2021.03.054. eCollection 2021 Jun.
Gastrostomy tube placement is an appropriate option for long-term nutritional support for patients who cannot tolerate oral intake. Common indications for a gastrostomy tube include head and neck tumors and neurological disorders. Several methods for gastrostomy tube insertion exist (eg, surgical, endoscopic, and radiologic) that require sedation or general anesthesia, which can pose risks of cardiopulmonary compromise and postsurgical pulmonary complications. Unlike other methods, our practice uses a percutaneous balloon-assisted gastrostomy tube insertion method for which we can perform without sedation. We report a case of a percutaneous radiologic gastrostomy procedure for a patient with end stage lung disease as a bridge to lung transplantation, who is not a candidate for sedation and is high-risk for general anesthesia. Through enteral feeds administered through the successfully placed gastrostomy tube, the patient showed steady improvement in weight gain over the course of several months before approval for listing by the lung transplant selection committee. Our case highlights how gastrostomy tube placement can be safely performed in patients who are not sedation candidates using the minimally invasive balloon-assisted gastrostomy tube insertion method and local anesthetic.
胃造口管置入术是为无法耐受经口摄入的患者提供长期营养支持的一种合适选择。胃造口管的常见适应证包括头颈部肿瘤和神经系统疾病。存在多种胃造口管插入方法（例如手术、内镜和放射学方法），这些方法需要镇静或全身麻醉，这可能带来心肺功能受损和术后肺部并发症的风险。与其他方法不同，我们的做法是使用经皮球囊辅助胃造口管插入法，该方法无需镇静即可进行。我们报告了一例为终末期肺病患者进行经皮放射学胃造口术的病例，该患者作为肺移植的过渡患者，不适合使用镇静剂且全身麻醉风险高。通过经成功置入的胃造口管给予肠内营养，在被肺移植选拔委员会批准列入名单之前的几个月里，患者体重稳步增加，情况持续改善。我们的病例突出表明，使用微创球囊辅助胃造口管插入法和局部麻醉，可为不适合使用镇静剂的患者安全地进行胃造口管置入术。
