MEDRADSC 3C03 Lecture Notes - Lecture 18: Gastric Varices, Gastrostomy, Gastrectomy
14 Jul 2018
School
Department
Course
Professor
Document Summary
A technique used to provide nutritional support for patients with: head & neck lesions, esophageal lesions, inadequate intake due to neurological disorders (ie. cva, trauma, decompression of chronic small bowel obstructions. Gastrostomy: performed to insert the tube ( g tube insertion , gastrostomy: hole/tunnel made into stomach percutaenously. Patients with g-tube are prone to gastroesophageal reflux and aspiration. If this is the case or if this is a concern a gj tube will be inserted (gastrojejunostomy) The initial insertion is the same in both cases- gj tubes are advanced around the duodenum into the first part of jejunum. Absolute: gastric varices, total gastrectomy, uncorrectable coagulopathy: bleeding disorders that can"t be controlled. Relative: ascites, partial gastrectomy, overlying colon, coagulopathy, inability to pass a nasogastic tube. Us or ct to map placement of the left lobe of the liver: reduce chance of hepatic puncture (hemorrhage or extravasation of bile, reduce inadvertent perforation of the transverse colon.
