Jaideep Das Gupta, MD, James Verlanic, MD, Nida Bham, MD, Adam Delu, MD, Neelakantan Prakash, MD, Jess Schwartz, MD. University of New Mexico
Background: Esophageal perforation carries a high morbidity and mortality rate if not treated appropriately and aggressively. The treatment for esophageal perforation includes medical management, endotherapy or surgery. Yet, for all options, feeding access and decompression remains an issue. Gastrojejunostomy (GJ) tube is a practical option to allow post-pyloric feeds and gastric decompression. However, there is difficulty placing GJ-tubes in a short and timely fashion after management of esophageal perforations.
Methods: We present a hybrid approach of endoscopic and fluoroscopic guided GJ tube placement for patients with esophageal perforations. Our institution used the EndoVive® (Boston Scientific, Natick, MA) enteral feeding devices for our cohort of patients.
Results: We employed the technique of placing GJ-tubes within two days after the initial management of the esophageal perforation for six patients. All patients successfully tolerated the procedure and enteral feeds without any complications.
Conclusion: Hybrid method of endoscopic and fluoroscopy guided placement of EndoVive® (Boston Scientific, Natick, MA) GJ-tube is ideal for gastric decompression and post-pyloric feeding access shortly after the initial management of an esophageal perforation.
Key Words: esophageal perforation; gastrojejunostomy tube; enteral feeding access; EndoVive® (Boston Scientific, Natick, MA)
Abbreviations: GJ-tube – Gastrojejunostomy tube; G-tube – Gastrostomy tube; IR – Interventional Radiology; PEG – Percutaneous endoscopic gastrostomy; TTP – Through the PEG; J-tube – Jejunostomy tube; LOT – Ligament of Treitz; GEJ – Gastroesophageal junction; NJ-tube – nasojejunal tubes.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94257
Program Number: P466
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster