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Title of Journal: Pediatr Radiol

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Abbravation: Pediatric Radiology

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Springer Berlin Heidelberg

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DOI

10.1007/s11082-016-0532-z

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1432-1998

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Peritonitis following percutaneous gastrostomy tub

Authors: Leema Dookhoo Sanjay Mahant Dimitri A Parra Philip R John Joao G Amaral Bairbre L Connolly
Publish Date: 2016/05/12
Volume: 46, Issue: 10, Pages: 1444-1450
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Abstract

Percutaneous retrograde gastrostomy has a high success rate low morbidity and can be performed under different levels of sedation or local anesthesia in children Despite its favourable safety profile major complications can occur Few studies have examined peritonitis following percutaneous retrograde gastrostomy in childrenWe conducted a retrospective case–control study of children who developed peritonitis within 7 days of percutaneous retrograde gastrostomy between 2003 and 2012 From the 1504 patients who underwent percutaneous retrograde gastrostomy patients who developed peritonitis group 1 were matched by closest date of procedure to those without peritonitis group 2 Peritonitis was defined according to recognized clinical criteria Demographic clinical procedural management and outcomes data were collectedThirtyeight of 1504 children 25 95 confidence interval 1835 who underwent percutaneous retrograde gastrostomy developed peritonitis ≤7 days post procedure group 1 Fever 89 irritability 63 and abdominal pain 55 occurred on presentation of peritonitis Group 1 patients were all treated with antibiotics 41 underwent additional interventions tube readjustments 8 aspiration of pneumoperitoneum 23 laparotomy 10 and intensive care unit admission 10 In group 1 enteral feeds started on average 3 days later and patients were discharged 5 days later than patients in group 2 There were two deaths not directly related to peritonitis Neither age gender weight underlying diagnoses nor operator was identified as a risk factorPeritonitis following percutaneous retrograde gastrostomy in children occurs in approximately 25 of cases No risk factors for its development were identified Medical management is usually sufficient for a good outcome Patients with peritonitis are delayed starting feeds and have a hospital stay that is an average of 5 days longer than those without

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