Gastrostomy

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“Placement of the Stoma Site. The stoma site on the abdominal wall should be placed away from the rib cage because, with the child’s growth, the distance between the two tends to become shorter. A gastric access device that is too close to the ribs will cause discomfort and interfere with care. Additionally, pivoting motion resulting from breathing and moving can lead to stoma enlargement and leakage. In small children, the linea alba tends to be broad and very thin and also should be avoided as an exit site. The stoma site on the stomach should be in the mid-body—away from the greater curvature, because the proximity to the transverse colon can lead to a gastrocolic fist…

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Video Link in second post

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see video link in second post

[size=20px]A three-year old boy had a laparoscopic fundoplication and gastrostomy at 20 months of age. The gastrostomy has not been used for the past three months and he has had adequate weight gain and growth. The family would like it removed. The factor most associated with persistent gastrocutaneous fistula after removal of the button is A size of the gastrostomy button. B interval since initial placement. C age of the patient. D history of fundoplication. E presence of a neurodevelopmental deficit.​[/size]

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see video link in second post