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Quick Summary
BOTTOM LINE
Percutaneous gastrostomy tube placement without opacification of the colon with barium reduced
radiation dose and fluoroscopy time. This method also makes the procedure more tolerable for the
patient by avoiding the need for oral barium and also less invasive by eliminating the need for
administration of rectal barium.
MAJOR POINTS
Sample consisted of 112 total patients (52 with barium, 60 without barium) met the inclusion
criteria within the designated
Analysis included fluoroscopy time, total radiation dose, dose-area product (DAP), time and weight
adjusted DAP
Patient who underwent the procedure without barium experienced a 50% or greater reduction in all
factors analyzed
Complications rates, including colonic perforation, were higher in the non-barium group however
the authors state that when compared to other literature this rate was comparable and therefore
they felt it was not actually increased in their study
CRITICISM
Retrospective study
Small sample size, creating the appearance of higher complication rates in non-barium group
Study design
Single Center Retrospective Review
2011-2013
INCLUSION CRITERIA
EXCLUSION CRITERIA
GJ tube patients
Purpose
Intervention
Stomach with distended via nasogastric tube; this is monitored using US and
fluoroscopy
Intervention
Outcome
Patient who underwent the procedure without barium experienced a 50% or greater reduction
in all factors analyzed
Credits
SUMMARY BY:
Steven Morales, MD
Department of Radiology
University of Iowa
Kelly B, Mullen E, Connolly B. Radiologic Retrograde Gastrostomy Tube Insertions Without the Use of Barium: Implications for
Radiation Dose in Children. American Journal of Radiology; 205: 1135-1138.
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