Ultrasound guidance in percutaneous gastrostomy and gastrojejunostomy.

OBJECTIVE

To evaluate the utility of ultrasound (US) guidance in the percutaneous placement of gastric feeding tubes in patients in whom placement of a nasogastric tube is not possible.

PATIENTS AND METHODS

Records from feeding tube placements performed between January 1991 and August 1994 were reviewed. Of the 238 procedures performed, 27 cases (11%) involved initial US guidance, rather than nasogastric tube assistance, because of upper gastrointestinal obstruction.

RESULTS

US allowed rapid puncture and subsequent insufflation of the stomach in 26 of the 27 patients, and there were no complications related to its use. In the other patient the position of the transverse colon prevented suitable visualization for puncture, and surgical placement of the feeding tube was necessary.

CONCLUSION

US guidance is a safe and effective means by which the stomach can be punctured and distended before placement of a percutaneous feeding tube for patients in whom nasogastric intubation is not possible.