Pediatric patients with intestinal failure often need gastrostomy tubes, or feeding tubes inserted into an opening created in the stomach, for long-term nutrition. The use of such tubes can lead to persistent gastrocutaneous fistulae, or the failure of the opening to close on its own, resulting in a need for surgical closure.
The causes of gastrocutaneous fistulae in pediatric patients are largely unknown, but researchers at Boston Children's Hospital looked at possible risk factors, including nutrition. Their finds are published today in the OnlineFirst version of the Journal of Parenteral and Enteral Nutrition (JPEN), the research journal of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.).
Of all the risk factors studied, only prolonged use of a gastrostomy tube was identified with an increased likelihood of gastrocutaneous fistulae. In addition, fistulas in pediatric patients that persist for longer than seven days are unlikely to close.
The researchers recommend that that early operative intervention be considered after a relatively brief trial of spontaneous gastrostomy tubes site closure, especially in children who have had indwelling tubes for longer than 18 months.