PROCEDURE: Gastrojejunostomy tube check and repositioning with imaging guidance

 

DATE: 01/01/2022

CLINICAL INDICATION: Mr.  73 year old male with hx of PD dx 12 years ago with a GJ tube placement on research protocol receiving meds through the J tube which now appears to be clogged.

OPERATING PHYSICIANS: John Doe, MD (Attending)/Jane Doe, MD (Fellow)

MEDICATIONS: 2% lidocaine without epinephrine for local anesthesia 

ACCESS: Existing gastrojejunostomy tube

CONTRAST: 15CC of nonionic contrast

FLUOROSCOPY TIME: 4.7 minutes

COMPLICATIONS: None

 

PROCEDURE: After written informed consent was obtained, the patient was placed supine on the procedure table. The abdomen and GJ tube were prepped and draped in standard sterile fashion. A scout image was obtained. Contrast was injected through both the gastrostomy and jejunostomy ports to confirm intraluminal location. A 0.035 inch stiff Glidewire was advanced through the jejunal port and the coiled portion of the jejunal tube looped in the duodenum was unfurled.  The Glidewire was removed. Contrast was injected through the jejunal port to confirm location. The tube was then flushed.

 

FINDINGS: Scout image shows a gastrojejunostomy tube projecting over the abdomen.  The new feeding tube follows a similar course and intraluminal positioning is confirmed with contrast injection.

 

IMPRESSION:  Successful gastrojejunostomy tube evaluation and repositioning as above.