Radiology, Vol 184, 201-205, Copyright © 1992 by Radiological Society of North America
CT guidance for percutaneous gastrostomy and gastroenterostomy
RB Sanchez, E vanSonnenberg, HB D'Agostino, BW Goodacre, P Moyers and G Casola
Department of Radiology, University of California, San Diego, Medical Center 92103.
The authors describe the value of computed tomographic (CT) guidance for
percutaneous gastrostomy (PG) or gastroenterostomy (PGE) in 22 patients
with anatomic or pathologic difficulties precluding fluoroscopic guidance.
Indications for PG or PGE were decompression for gastrointestinal
obstruction (n = 15) or for feeding (n = 7). Thirteen patients previously
underwent an unsuccessful attempt at or had been rejected as unsuitable for
percutaneous endoscopic gastrostomy. CT guidance was selected because of
inability to pass a nasogastric tube due to esophageal obstruction (n = 4),
inability to tolerate gastric distention (n = 1), abnormal morphology in or
around the stomach (n = 16), or simultaneous performance of a PG in one
patient who was undergoing emergency CT-guided abscess drainage. Catheters
were placed successfully in all 22 patients. No major complications
occurred. CT is valuable for PG or PGE when anatomic or pathologic problems
make fluoroscopic or endoscopic puncture unsafe or impossible.
