Nasojejunal feeding tube placement in children: four-year cumulative experience.

Abstract

Experience with fluoroscopically guided nasojejunal feeding tube placement in children was assessed regarding clinical diagnosis, fluoroscopy time, radiation dose, success rate, and placement failures. From 1987 to 1991, 562 nasojejunal tubes were placed in 232 patients aged 1 week to 24 years (mean, 3 1/2 years) at the authors' institution. In every case, an 8-F feeding tube system was inserted. The fluoroscopy times and tube placement positions were evaluated in all cases. The mean fluoroscopy time was 5 minutes 30 seconds, which corresponded to an estimated mean midline fluoroscopy dose of 0.32 cGy. The tube was placed at or distal to the duodenojejunal junction in 543 attempts, for a success rate of 97%. The most common cause for unsuccessful tube placement was malrotation, with the fluoroscopic time and radiation dose significantly (P < .001) prolonged in these cases. Fluoroscopic guidance of placement of nasojejunal feeding tubes in children is successful, but the radiation exposure is not negligible and must be weighed against the need for nasojejunal feeding.