A Dislodged Gastrostomy Tube

Enteral feeding tubes are one of the most common devices encountered in the care of medically complex children. When a G-tube has been removed inadvertently, either another feeding tube or a Foley catheter should be used as an immediate placeholder to prevent the stoma from closing. Early dislodgement of a G-tube (6 weeks or less since initial placement) requires evaluation in the emergency room or clinic by the surgical team that placed the tube to ensure that a false tract is not created. Peristomal leakage from an enlarged stoma is best treated by properly securing the tube and applying a barrier cream to prevent skin irritation. Placing a larger G-tube into the stoma will only cause further enlargement and leakage. Hypergranulation tissue that is red, beefy, and raised can be managed with either silver nitrate or triamcinolone cream.