What the radiologist should know about the role of percutaneous gastrostomy: a pictorial essay

Tibana, Tiago Kojun; Verza, Leonardo; Rodrigues, Bernardo Caetano da Silva; Monsignore, Lucas Moretti; Abud, Daniel Giansante; Nunes, Thiago Franchi

doi:10.1590/0100-3984.2021.0066

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Pictorial Essay • Radiol Bras 55 (3) • May-Jun 2022 • https://doi.org/10.1590/0100-3984.2021.0066-en linkcopy

What the radiologist should know about the role of percutaneous gastrostomy: a pictorial essay

Authorship SCIMAGO INSTITUTIONS RANKINGS

The image-guided gastrostomy techniques, as transoral and transabdominal, can be performed when there is a failure of the endoscopic procedure or in some specific clinical scenarios. This pictorial essay intends to show the percutaneous gastrostomy techniques, indications, technical approaches, post-procedure care, and complications.

Keywords:
Gastrostomy; Radiology, interventional; Fluoroscopy; Tomography, X-ray computed

Authorship

person Tiago Kojun Tibana

schoolDepartment of Vascular and Interventional Radiology, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.Universidade Federal de Mato Grosso do Sul (UFMS)BrazilCampo Grande, MS, BrazilDepartment of Vascular and Interventional Radiology, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.

0000-0001-5930-1383

person Leonardo Verza

schoolDepartment of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil.A.C.Camargo Cancer CenterBrazilSão Paulo, SP, BrazilDepartment of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil.

0000-0002-1287-6056

person Bernardo Caetano da Silva Rodrigues

schoolDepartment of Interventional Radiology, Hospital Federal Ipanema (HFI), Rio de Janeiro, RJ, Brazil.Hospital Federal Ipanema (HFI)BrazilRio de Janeiro, RJ, BrazilDepartment of Interventional Radiology, Hospital Federal Ipanema (HFI), Rio de Janeiro, RJ, Brazil.

0000-0003-4936-9143

person Lucas Moretti Monsignore

schoolDivision de of Interventional Radiology, Department of Radiology, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.Universidade de São PauloBrazilRibeirão Preto, SP, BrazilDivision de of Interventional Radiology, Department of Radiology, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.

0000-0003-2345-4921

person Daniel Giansante Abud

0000-0002-6171-669X

person Thiago Franchi Nunes

0000-0003-0006-3725

Correspondence: Dr. Tiago Kojun Tibana. Departamento de Radiologia Intervencionista e Vascular, Universidade Federal de Mato Grosso do Sul. Avenida Senador Filinto Müller, 355, Vila Ipiranga. Campo Grande, MS, Brazil, 79080-190.
tiagotibana@hotmail.com.

SCIMAGO INSTITUTIONS RANKINGS

Department of Vascular and Interventional Radiology, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.Universidade Federal de Mato Grosso do Sul (UFMS)BrazilCampo Grande, MS, BrazilDepartment of Vascular and Interventional Radiology, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.

Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil.A.C.Camargo Cancer CenterBrazilSão Paulo, SP, BrazilDepartment of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil.

Department of Interventional Radiology, Hospital Federal Ipanema (HFI), Rio de Janeiro, RJ, Brazil.Hospital Federal Ipanema (HFI)BrazilRio de Janeiro, RJ, BrazilDepartment of Interventional Radiology, Hospital Federal Ipanema (HFI), Rio de Janeiro, RJ, Brazil.

Division de of Interventional Radiology, Department of Radiology, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.Universidade de São PauloBrazilRibeirão Preto, SP, BrazilDivision de of Interventional Radiology, Department of Radiology, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.

Figures

Figures (7)

Thumbnail

Figure 1 In A, a kit used for transabdominal insertion with fasteners (arrows). In B, schematic demonstrating the puncture (arrow) between the fasteners.

Thumbnail

Figure 2 CT-guided retrograde gastrostomy. In A, gastropexy. In B, puncture between the fasteners (arrows). In C, final appearance with an inflated cuff (arrows) inside the stomach.

Thumbnail

Figure 3 Fluoroscopy-guided retrograde gastrostomy. In A, gastropexy (arrows). In B, puncture between the fasteners. In C, guidewire inside the stomach. In D, final appearance with the tube in place (arrows).

Thumbnail

Figure 4 In A, percutaneous endoscopic gastrostomy system used in fastener-free antegrade techniques with a mushroom-tipped tube (arrow). In B, position of the sheath (arrow) within the stomach.

Thumbnail

Figure 5 Gastric distention with saline solution (arrows in A) and ultrasound-guided puncture (arrows in B).

Thumbnail

Figure 6 Fluoroscopy-guided antegrade gastrostomy. In A, contrast infusion through the nasogastric tube (arrows) and stomach insufflation (arrowheads). In B, guidewire (arrows) and catheter (arrowhead) along the path from the stomach to the esophagus and to the mouth. In C, gastrostomy tube being positioned (arrows). In D, final positioning of the gastrostomy tube (arrows).

Thumbnail

Figure 7 Fluoroscopy-guided antegrade gastrostomy. In A, capture of the hydrophilic guidewire by the snare. In B and C, the final appearance, with contrast injection through the tube (arrows).

imageFigure 1 In A, a kit used for transabdominal insertion with fasteners (arrows). In B, schematic demonstrating the puncture (arrow) between the fasteners. open_in_new

imageFigure 2 CT-guided retrograde gastrostomy. In A, gastropexy. In B, puncture between the fasteners (arrows). In C, final appearance with an inflated cuff (arrows) inside the stomach. open_in_new

imageFigure 3 Fluoroscopy-guided retrograde gastrostomy. In A, gastropexy (arrows). In B, puncture between the fasteners. In C, guidewire inside the stomach. In D, final appearance with the tube in place (arrows). open_in_new

imageFigure 4 In A, percutaneous endoscopic gastrostomy system used in fastener-free antegrade techniques with a mushroom-tipped tube (arrow). In B, position of the sheath (arrow) within the stomach. open_in_new

imageFigure 5 Gastric distention with saline solution (arrows in A) and ultrasound-guided puncture (arrows in B). open_in_new

imageFigure 6 Fluoroscopy-guided antegrade gastrostomy. In A, contrast infusion through the nasogastric tube (arrows) and stomach insufflation (arrowheads). In B, guidewire (arrows) and catheter (arrowhead) along the path from the stomach to the esophagus and to the mouth. In C, gastrostomy tube being positioned (arrows). In D, final positioning of the gastrostomy tube (arrows). open_in_new

imageFigure 7 Fluoroscopy-guided antegrade gastrostomy. In A, capture of the hydrophilic guidewire by the snare. In B and C, the final appearance, with contrast injection through the tube (arrows). open_in_new

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