Gastrointestinal Radiology > Procedures > CT-Guided Perc. Gastrostomy > CT-Guided Perc. Gastrostomy (9)


CT-Guided Percutaneous Gastrostomy: A Tutorial

Step 13: Exchange the final dilator for the gastrostomy tube. The gastrostomy tube we use is a 12- or 14-French locking abscess drainage catheter. Confirm intraluminal location of the gastrostomy tube with axial slices or CT-fluoroscopy, then remove the guidewire and lock the gastrostomy tube (pigtail).

Gastrostomy tube being advanced over guidewire

 A pneumoperitoneum will almost certainly be present - an expected occurrence.

Note pneumoperitoneum (arrow)

 

Lock the catheter pigtail to secure the tube in the gastric lumen

Step 14: Secure the gastric tube to the abdominal wall. We use a Percu-Stay Percutaneous Drainage Catheter Fastener (Derma Sciences, Princeton, NJ, USA), consisting of an adhesive catheter fixation mechanism that is attached to the skin.

Tube affixed to the abdominal wall

Step 15: Transfer the patient from the CT suite to an observation station for recovery from sedation.



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