Safety and outcome of gastrostomy tube placement in patients with Loeys-Dietz syndrome

• Published in: BMC gastroenterology Vol. 20; no. 1; p. 71
• Main Authors: Frischmeyer-Guerrerio, Pamela A, MacCarrick, Gretchen, Dietz, Harry C, Stewart, F Dylan, Guerrerio, Anthony L
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12-03-2020; BioMed Central; BMC
• Subjects: Adolescent; Allergy; Body Mass Index; Care and treatment; Child; Child, Preschool; Connective tissue diseases; Connective tissue disorder; Diseases; Enteral Nutrition - adverse effects; Enteral Nutrition - methods; Failure to thrive; Follow-Up Studies; Food hypersensitivity; G-tube; Gastroenterology; Gastrointestinal; Gastrointestinal diseases; Gastrointestinal intubation; Gastrostomy; Gastrostomy - adverse effects; Genetic disorders; Humans; Infant; Inflammation; Intestine; LDS; Loeys-Dietz Syndrome - surgery; Medical research; Medical supplies; Ostomy; Patient outcomes; PEG; Postoperative Complications; Retrospective Studies; Therapeutics; Time; Treatment Outcome; Weight Gain; Wound care; Wound healing; Wounds; United States; Connective tissue disorder; G-tube; GI; Failure to thrive; PEG; LDS; Gastrointestinal
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-020-01213-2

Loeys-Dietz syndrome (LDS) is a systemic connective tissue disease (CTD) associated with a predisposition for intestinal inflammation, food allergy, and failure to thrive, often necessitating nutritional supplementation via gastrostomy tube. Poor wound healing has also been observed in in some patients with CTD, potentially increasing the risk of surgical interventions. We undertook to determine the safety and efficacy of gastrostomy tube placement in this population.
We performed a retrospective cohort study of 10 LDS patients who had a total of 12 gastrostomy tubes placed.
No procedural complications occurred, although one patient developed buried bumper syndrome in the near post-procedural time period and one patient had a small abscess at a surgical stitch. Most patients exhibited improvements in growth, with a median immediate improvement in BMI Z-score of 0.2 per month following the institution of gastrostomy tube feedings. Those with uncontrolled inflammation due to inflammatory bowel disease or eosinophilic gastrointestinal disease showed the least benefit and in some cases failed to demonstrate significant weight gain despite nutritional supplementation.
Gastrostomy tube placement (surgical or endoscopic) is a generally safe and a reasonable therapeutic option for patients with LDS despite their underlying CTD.