Consult interventional radiology for replacement
Discharge, close follow up with PMD
Surgery consultation
G-J tube?
Iohexol (omnipaque) or Iopamidol (isovue) dye study
Consult surgery for replacement
Procedure to preserve stoma opening
Immature tube or difficult replacement?
Able to aspirate gastric contents?
Wait 10 min, reposition patient and again try to aspirate gastric contents
Replace gastrotomy tube. Do not use a q-tip or use force to insert GT into tract
Consult surgery or interventional radiology
Determine original service who placed tube and if this is the first replacement OR there is an immature tract
Original service | Immature | Mature |
Interventional radiology | ≤12 wks | >12 wks |
Surgery | ≤6 wks | >6 wks |
Consider sending the patient home with a replacement GT or a 10F Foley and lubricant that the parent can place if the GT/GJ tube dislocates in the future and they cannot replace the GT/GJ.
Important historical questions
Gastrotomy tube replacement