Comparison of Gastrostomy Tube Replacement Verification Using Air Insufflation Versus Gastrograffin

Abstract

Burke DT, El Shami A, Heinle E, Pina B. Comparison of gastrostomy tube replacement verification using air insufflation versus gastrograffin. Objective To compare the safety of air insufflation as a contrast medium for percutaneous endoscopic gastrostomy (PEG) tube replacement verification with that of the more traditional method using positive contrast material (gastrograffin) under fluoroscopic guidance. Design Retrospective case series comparing 2 radiographic procedures used for PEG tube verification at a rehabilitation hospital. The first series reviewed studies of patients over 1 year, during which the method of choice for PEG tube replacement verification was with air insufflation. The second series reviewed studies of patients over the subsequent year, during which the method of choice for PEG tube replacement verification was with gastrograffin. Setting An inpatient rehabilitation hospital. Participants Nineteen patients and 29 PEG tube replacements were identified that used air insufflation and 17 patients and 19 PEG tube replacements were identified that used gastrograffin. Interventions Not applicable. Main Outcome Measures Medical complications in a 2-week follow-up period as a result of the verification procedures. Results There were no cases in either of the replacement procedures in which the PEG tube was found to not be in the gastrointestinal system. There was also no evidence at 2-week follow-up that any of the patients’ complications were the result of either procedure. Conclusions The air contrast procedure appears to be a relatively safe alternative procedure for PEG tube replacement verification.