Gastric prolapse through a gastrostomy tract.

BACKGROUND/PURPOSE: Few reports have documented the incidence or the characteristics of children with gastric prolapse through a gastrostomy tract. The purpose of this report was to determine the incidence of gastric prolapse through a gastrostomy tract and to identify the salient features associated with gastric prolapse.

METHODS

This was a retrospective review of 1,042 children from The Children's Hospital, Denver, CO who had a gastrostomy constructed for enteral access between 1992 and 2002. The charts of children who had gastric prolapse through the gastrostomy tract were scrutinized to obtain a profile of the children who had prolapse, and 14 parameters were analyzed for correlation with the incidence of this complication.

RESULTS

Thirteen children had gastric prolapse through the gastrostomy tract for an incidence of gastric prolapse of 1.2%; 5 children had recurrent gastric prolapse through a gastrostomy tract for an incidence of recurrent gastric prolapse of 0.5%. Gastric prolapse occurred more often in children with ventilator dependence (31%), poor nutrition (54%), and neurologic disorders (58%). Gastrostomy devices with both ends fixed and rigid were associated with gastric prolapse (2.7%) more often than devices with only 1 end fixed and rigid (0.6%). Laparoscopic gastrostomy was associated with gastric prolapse and recurrent gastric prolapse more often than other gastrostomy construction techniques.

CONCLUSIONS

Children with poor nutrition, ventilator dependence, a neurologic disorder, a gastrostomy device with both ends fixed and rigid, and/or a laparoscopic gastrostomy, were prone to gastric prolapse.