How is the placement of the gastrostomy tube replacement confirmed?

Updated: May 26, 2020
  • Author: Erik D Schraga, MD; Chief Editor: Vikram Kate, MBBS, MS, PhD, FRCS, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed)  more...
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Answer

Before the G-tube is used for feedings, placement must be confirmed. [14] Classically, confirmation is achieved by injecting 20-30 mL of water-soluble contrast solution (diatrizoate meglumine diatrizoate sodium) into the tube and taking a supine abdominal radiograph within 1-2 minutes. This is best done in the radiography suite. Barium should never be used, because its injection into the peritoneal cavity can be devastating.

If the tube is placed properly, contrast outlines the stomach on the radiograph. A study comparing verification of G-tube replacement with air insufflation versus contrast radiography determined the two methods to be equal in efficacy. [15] However, obtaining a contrast radiograph is generally considered the current standard of care.

In pediatric patients, point-of-care ultrasonography (POCUS) is an attractive option for confirmation of G-tube reinsertion in the ED [16] ; however, further studies are needed to confirm the efficacy of this technique.


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