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Enteric Feeding with Gastric Decompression: Management with Separate Gastric Accesses

Brian C. Lucey1, Debra A. Gervais1, Ross L. Titton1, Fiona O'Hare1, Peter F. Hahn1, Michael Maher1 and Peter R. Mueller1,2

1 Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, Boston, MA 02114-9657.
2 Department of Radiology, Harvard Medical School, White 270, 55 Fruit St., Boston, MA 02114-9657.



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  		Fig. 1. —Fluoroscopic image of 68-year-old man who had undergone anatomy-altering upper gastrointestinal tract surgery shows angle required for introducer trocar (long straight arrows) for placement of drainage gastrostomy tube. This angle will allow placement of tip in gastric fundus. Biliary drainage catheter (curved arrow) is in situ on right. Feeding catheter is seen on left (short straight arrow).

 


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  		Fig. 2A. —63-year-old man with drainage gastrostomy tube and gastrojejunostomy tube. Fluoroscopic image shows angle required for introducer trocar (straight arrows) for placement of gastrojejunostomy tube. This angle allows easier passage of guidewire through pylorus and beyond ligament of Treitz. Drainage gastrostomy tube (curved arrow) is in situ.

 


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  		Fig. 2B. —63-year-old man with drainage gastrostomy tube and gastrojejunostomy tube. Fluoroscopic image obtained after procedure shows positions of catheter tips for both drainage gastrostomy tube (black arrow) and gastrojejunostomy tube (white arrow) are satisfactory.

 


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  		Fig. 3. —Fluoroscopic image of 74-year-old woman who had undergone partial gastrectomy shows gastrostomy tube (arrow) with tip in fundus. Feeding gastrojejunostomy tube is directed caudad.

 


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  		Fig. 4. —Fluoroscopic image shows gastrostomy (white arrow) and gastrojejunostomy (black arrow) tubes in 76-year-old man who had prior Whipple procedure.

 

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