Skip to main content
. 2011 May;16(5):281–287. doi: 10.1093/pch/16.5.281

TABLE 1.

Common paediatric gastrostomy (G) and gastrojejunostomy (GJ) tube devices

Tube Indication Advantages Disadvantages
Pigtail G tube
eg, Dawson-Mueller Mac-loc pigtail (COOK Medical Inc, USA)
Inline graphic
Initial G tube used in the PRG technique Available in a variety of sizes: 8.5–14 Fr

Looped (pigtail) versus balloon distal end secures tube in stomach. Balloon devices can deflate, resulting in migration
No external anchoring device – tube must be taped to skin to prevent migration
Taping of tube can cause skin breakdown and/or allergic dermatitis
Smaller bore tubes can easily become blocked
Tube must be replaced under fluoroscopy
GJ tube
eg, COOK GJ tube (COOK Medical Inc, USA)
Inline graphic
Initial and replacement GJ tube used in the PRG technique Gastric coil secures tube in stomach and looped (pigtail) distal end secures tube in jejunum
Nonsurgical option for management of severe gastroesophageal reflux disease in children at high risk for aspiration
No external anchoring device – tube must be taped to skin to prevent migration
Distal end of tube can migrate from jejunum into stomach
Taping tube to skin can cause skin breakdown and/or allergic dermatitis
Smaller bore tubes can easily become blocked
Tube must be replaced under fluoroscopy
Looped distal end and tubes with a large bore size can increase the risk of intussusception
Not available in a low-profile device
PEG tube
eg, MIC-PEG Feeding Tube (Kimberly-Clark Worldwide Inc, USA)
Inline graphic
Initial G tube used in the percutaneous endoscopic gastrostomy procedure Bulb tip secures tube in stomach and external retention ring anchors tube
Bulb tip does not deflate
Not available under 14 Fr
Device can be too big and heavy for small paediatric patients
External retention ring moves and loosens over time, increasing risk of migration
External retention ring can make cleaning of the stoma difficult, increase moisture around stoma and result in skin breakdown, infections, enlarged stomas and granulation tissue
Taping tube to skin can cause skin breakdown and/or allergic dermatitis
Balloon G tube
eg, MIC G tube (Kimberly-Clark Worldwide Inc, USA)
Inline graphic
Replacement G tube device Water-inflated balloon secures tube in stomach and external retention ring anchors tube
Tube can be replaced by most trained health care providers and caregivers without the need for fluoroscopy or sedation
Not available in sizes smaller than 12 Fr
Device can be too big and heavy for small paediatric patients
External anchoring device moves and loosens over time, increasing risk of migration
External retention ring can make cleaning of the stoma difficult, increase moisture around stoma and result in skin breakdown, infections, enlarged stomas and granulation tissue
Balloon device can deflate, resulting in migration and/or need for replacement
Taping tube to skin can cause skin breakdown and/or allergic dermatitis
Low-profile balloon G tube
eg, MIC-KEY Low-Profile G tube (Kimberly-Clark Worldwide Inc, USA)
Inline graphic
Replacement G tube device
A measuring device determines tube length
Water-inflated balloon secures tube in stomach
Low-profile device that does not migrate easily
Does not require taping to skin for anchoring
Proper stoma care is easy to provide
Tube can be replaced by most trained health care providers and caregivers without the need for fluoroscopy or sedation
Tubes start at 12 Fr and are less likely to become blocked
Tube length must be appropriately sized for each patient to prevent migration and skin breakdown
Balloon device can deflate or break, resulting in migration and/or the need for replacement
Tube bore size starts at 12 Fr and may not be an option for small paediatric patients
Tube and extension sets are costly
Low-profile bulb G tube
eg, BARD button (BARD Inc, USA)
Inline graphic
Replacement G tube device
A measuring device determines tube length
Internal bulb secures tube in stomach versus balloon
Durable (1–2 years)
Low-profile device that does not migrate easily
Does not require taping to skin for anchoring
Proper stoma care is easy to provide
Tube must be inserted with an introducer, which is painful and increases the risk of perforation
Patient may require sedation and/or fluoroscopy for the procedure, which must be performed by trained health care providers
Leakage through external valve is common
Tube bore size starts at 16 Fr and may not be an option for small paediatric patients
Tube and extension sets are costly
Tube should be replaced at 18–24 months to avoid tube breaking at the time of removal. If the internal bulb remains in the stomach, it can cause intestinal obstruction
Tube is removed by direct traction, which can be painful and cause trauma to the stoma
Low-profile balloon transgastric-jejunal tube
eg, MIC-KEY Low Profile Transgastric-jejunal feeding tube (Kimberly-Clark Worldwide Inc, USA)
Inline graphic
Replacement GJ tube with gastric outlet for venting Nonsurgical option for management of severe gastroesophageal reflux disease
Low-profile device
Large bore size reduces the risk of blockage
Tube bore size starts at 16 Fr and may not be an option for small paediatric patients
Bore size can increase the risk of intussusceptions
Leakage through external valve is common
Tube must be replaced under fluoroscopy
Tube and extension sets are costly

PRG Percutaneous retrograde gastrostomy