Radiology &

Imaging

A gastrostomy is a direct opening from your abdominal wall into your stomach through which you can be fed.

This procedure is performed when you cannot swallow either because you have had a stroke or you have developed another problem that makes it hard for you to swallow. Most of the time gastrostomy is a temporary measure, but sometimes it is permanent.

The procedure is performed in two basic ways. The first way, called percutaneous endoscopic gastrostomy (PEG) tube placement, is an outpatient procedure performed under mild sedation and a local anesthetic. Your doctor will guide a flexible endoscope through your mouth and into your stomach. An endoscope is a long, narrow tube with a camera and light on the end of it. It lets your doctor look into the inside of your stomach. Your doctor will fill your stomach with air to make it bigger. He or she will guide a needle through your skin and abdominal wall and into your stomach. The doctor then will place a wire through the needle, retrieve it with the endoscope and bring it out the mouth. The doctor will thread a tapered plastic tube over the wire through your mouth and pull it through the small hole in your abdomen. He or she will secure the tube to your skin.

The second approach, open or surgical gastrostomy, is performed in the operating room, usually under a general anesthetic. This puts you to sleep, relaxes your muscles, and keeps you from feeling pain. The surgeon will make a small incision in your upper abdominal wall and expose your stomach. Then he or she will make a cut through the wall of your stomach and place a tube through the skin into the stomach. The surgeon will then sew up the incision on your abdominal wall and fix the tube to the skin.

If you have an open surgical gastrostomy, you will be taken back to your hospital room. You may stay in the hospital for one to three days, based on your condition. You may be fed directly into a vein for one or two days. Later, you will be fed by a nurse or instructed how to feed yourself through the gastrostomy tube. You may be shown how to care for the tube.

You will be able to get enough nutrition.

The tube must stay in place for two months before it can be removed. You may need to have the tube changed periodically (every 6 to 12 months). The area around the tube may become infected after the operation. You should ask your doctor how these risks apply to you.

Call the doctor at Emory immediately if:

• The tube comes out — it must be replaced within a few hours.
• You think the tube is becoming blocked.
• You are unable to take food through the tube.
• You have a lot of drainage around the tube.
• You have increasing pain, redness or swelling near the tube.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.