Frank Cailin, Williams Regan F, Boulden Thomas, Kink Rudy, Paton Elizabeth A
Division of Pediatric Emergency Medicine, Department of Pediatrics, Le Bonheur Children's Hospital, 848 Adams Ave, Memphis, TN 38103, United States; University of Tennessee Health Science Center, 800 Madison Ave, Memphis, TN 38103, United States.
University of Tennessee Health Science Center, 800 Madison Ave, Memphis, TN 38103, United States; Division of Pediatric Surgery, Le Bonheur Children's Hospital, 848 Adams Ave, Memphis, TN 38103, United States.
J Pediatr Surg. 2022 Oct;57(10):390-395. doi: 10.1016/j.jpedsurg.2022.01.024. Epub 2022 Jan 31.
Gastrostomy tube (GT) dislodgement is a common cause of Pediatric Emergency Department (PED) visits. Postoperative patients and those who require stoma dilation are more likely to have complications during emergent replacement. Although incorrect replacement can cause significant morbidity overall, the occurrence is infrequent. Contrast injection of the GT is considered the standard for confirming proper placement. Case reports in both pediatric and adult patients suggest that ultrasound can be used to confirm proper replacement. The objective of the present study was to assess the utility of ultrasound to confirm GT placement in pediatric patients most at risk for complications from incorrect replacement.
This is a non-randomized cohort pilot trial to determine the sensitivity and specificity of ultrasound to confirm proper replacement of a GT in a Pediatric Emergency Department.
We enrolled 55 pediatric subjects, of which 50 had ultrasound imaging after GT replacement in the PED prior to contrast injection. Ultrasound was found to have 96% sensitivity and 100% specificity for confirming GT placement.
Ultrasound is a safe and reliable confirmatory study to confirm GT placement in pediatric patients, especially those at highest risk of complications from incorrect placement.
II.
胃造口管（GT）移位是儿科急诊科（PED）就诊的常见原因。术后患者以及需要造口扩张的患者在紧急更换胃造口管期间更易出现并发症。虽然不正确的更换总体上会导致严重的发病率，但这种情况并不常见。注入造影剂被认为是确认胃造口管正确放置的标准方法。儿科和成人患者的病例报告表明，超声可用于确认胃造口管的正确更换。本研究的目的是评估超声在确认最易因不正确更换而出现并发症的儿科患者胃造口管放置情况时的效用。
这是一项非随机队列试点试验，旨在确定超声在儿科急诊科确认胃造口管正确更换的敏感性和特异性。
我们纳入了55名儿科受试者，其中50名在儿科急诊科更换胃造口管后、注入造影剂前接受了超声检查。结果发现，超声确认胃造口管放置的敏感性为96%，特异性为100%。
超声是一种安全可靠的确认性检查，可用于确认儿科患者胃造口管的放置情况，尤其是那些因放置不正确而出现并发症风险最高的患者。
II级。
