Gastrointestinal Radiology > Procedures > CT-Guided Perc. Gastrostomy > CT-Guided Perc. Gastrostomy (11)

CT-Guided Percutaneous Gastrostomy: A Tutorial

Discussion

CT-guided percutaneous gastrostomy is a useful technique in patients who are poor endoscopic and/or fluoroscopic candidates.  The use of radiologic guidance may be preferable in some patients with oropharyngeal, esophageal, or gastric cancer, as tumor seeding by the endoscope can be avoided.

In patients with esophageal stenosis, a pediatric feeding tube (3 mm) can be used for gastric air insufflation. An added advantage of CT-guided percutaneous gastrostomy in patients with esophageal obstruction or stenosis the creation of a potential endoscopic access site. That is, the gastrostomy tract can be dilated up to accommodate an endoscope for patients who need endoscopic monitoring or therapy. Recent innovations in CT-guided feeding tube placement include percutaneous duodenostomy, percutaneous jejunostomy, and transhepatic approach for percutaneous gastrostomy.