THÔNG TIN TÀI LIỆU
overdilation can occur if medications or flushes are erroneously administered via the balloon port A patient with gastric ulcer caused by mechanical trauma presents with symptoms similar to other ulcer patients Common symptoms are abdominal pain, irritability, hematemesis, hematochezia, and coffee ground gastric drainage from the G-tube lumen Saline lavage should be performed If the fluid obtained is nonbloody, medications such as H2 -blockers other than ranitidine, antacids, and sucralfate may be administered and upper endoscopy should be scheduled The G-tube should be changed and the patient’s symptoms should be monitored carefully Gastric Outlet Obstruction Gastric outlet obstruction is a rare but serious complication of G-tubes It is usually the result of the migration of the tube tip into the pyloric channel Occasionally, the G-tube can migrate superiorly and block the esophagus In very rare cases, the entire apparatus can migrate distally, resulting in gastric outlet obstruction The child has retching or sudden onset of emesis and appears uncomfortable The G-tube needs to be pulled back to its proper location until it is snug against the abdominal wall If this procedure is not successful, the tube must be removed completely Stomal Complications Irritant Dermatitis/Allergic Hypersensitivity Skin irritation around the stoma may result from chronic leakage of gastric or jejunal fluid around the tube If the stoma widens, the leakage may become excessive, resulting in more significant dermatitis Adhesives and cleansing solutions may result in an allergic rash around the stoma The peristomal skin should be thoroughly cleansed and dried before assessment Small vesicular lesions with surrounding erythema suggest irritant dermatitis Treatment includes keeping the area as dry as possible and using barrier creams to protect the skin from further breakdown Stomahesive Powder (Convatec, Princeton, NJ) is useful for molding to the skin surface and keeping the area dry and free of debris In addition, identifying and treating the cause of the leakage are important If the leakage is caused by an enlarged stoma, surgical intervention may be required in the near future Hypergranulation Tissue Children with G- and J-tubes may develop hypergranulation tissue in the peristomal area, extending beyond the wound bed Although these granulomatous lesions may be harmless, they can be distressing to
Ngày đăng: 22/10/2022, 20:55
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