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GT and GJ tubes are common feeding methods in many pediatric patients. A frequent complication of these devices is that they can be accidentally removed (on average 1 ED visit per patient per year). Although there are risks associated with replacement of the tube, a majority of patients have the tube replaced with no difficulty.
G-tube replacement should be accomplished with the least invasive method. In patients where the tube has been out of the stoma for several hours, closure of the stoma may occur. Serial dilations with increasing sized Foley catheters may be necessary. Forcing or excessive manipulation may be associated with an increased risk of false tract creation and should be avoided.
Although severe complications are possible with any replacement of at GT, they are generally rare if proper technique is used and gastric contents are able to be aspirated. High risk patients include those with their first replacement, immature pathway tract or difficulty with GT replacement. In these cases (an other high risk situations or populations) the use of a confirmatory imaging with radiographic contrast material is recommended.
Until the g-tube tract has fully granulated and matured, there is an increased risk of false tract replacement of tube with subsequent peritonitis, sepsis and other severe complications. In patients with new tubes proper selection of the provider most skilled to replace the tube is necessary.