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Stoma Dilation
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I want to share an experience we had with re-inserting a G-tube button after it had been out for too long. Our 26-year-old son, Will, woke us up at 4:00 a.m. one day to say that his button had come out at some point overnight. We jumped into action to put a new one in, but the stoma had tightened too much. We didn’t have a small enough Foley catheter at home to insert either, so we headed to the emergency department (ED).

Thankfully the nurses there got us into a room quickly and gave us a small Foley catheter that we were able to insert to keep the stoma from closing further. Also thankfully, the doctor there agreed that the right process is to insert a small catheter, then move to a bigger one to re-open the stoma. They inflated the balloon along the way to open the stoma further.

The doctor offered pain relievers for the process, but our Will toughed it out. It was not fun and was definitely uncomfortable for him. My takeaway: From now on, we will make sure we have a small Foley catheter at home that we can insert if the button has come out and we don't immediately know about it. No doubt further closure had occurred during the two hours between finding the button was out and getting the small catheter in at the hospital.

I thought this was a tip worth sharing with families. Of course, you have to be comfortable doing this and knowledgeable about how to carefully do it, but I expect most families living with a G-tube long term get there.

—Valinda W.

Editor’s Note:

               Valinda also brought the following article to our attention: “Replacement of Dislodged Gastrostomy Tubes after Stoma Dilation in the Pediatric Emergency Department,” S. Bhambani, T. Phan, L. Brown, and A. Thorp (Western Journal of Emergency Medicine, April 19, 2017; westjem.com/original-research/replacement-of-dislodged-gastrostomy-tubes-after-stoma-dilation-in-the-pediatric-emergency-department.html). The authors conducted a retrospective medical record review of children up to 18 years old who came to one pediatric ED “with a dislodged GT [G-tube] that required stoma dilation by pediatric emergency physicians with serially increasing Foley catheter sizes prior to successful placement of the GT.”

               They “reviewed a total of 302 encounters in 215 patients, with 97… encounters requiring stoma dilation prior to replacing a GT. The median amount of dilation was 2 French between the initial Foley catheter size and the final GT size. There was a single complication of a mal-positioned balloon that was identified at the index visit. No delayed complications were encountered.”

               They conclude that the practice “is generally successful and without increased complication.” They continue, “All patients received at least one form of confirmation for appropriate GT placement with the most common being aspiration of gastric contents.”


LifelineLetter, September/October, 2018

 

This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.

 

Updated in 2015 with a generous grant from Shire, Inc. 

 

This website was updated in 2015 with a generous grant from Shire, Inc. This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.
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