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Percutaneous Cecostomy Insertion - Complications - |
| We have successfully placed 128 cecostomy tubes since 1994. In the initial period, learning to use the tube effectively can be quite stressful for the patient and family. Two patients have had their catheters removed due to emotional complications. The failure of antegrade enemas to alleviate incontinence in another patient was likely due to Hirschsprung's disease and the procedure in retrospect should not have been performed. Early complications include some pain at the site, which is successfully treated with oral analgesics. Several patients have developed local tenderness and required IV antibiotics for a total of five days. We have seen no incidence of cellulitis, (Maginot, 1993) but have treated one patient for deep soft tissue abscess by percutaneous drainage. Late complications seen in two patients were directly related to the volume of the phosphate enema. The dose was reduced and vomiting ceased. One of our patients had a bleeding episode following trauma to the exit site that resolved without any treatment. Several patients have pulled the catheters out inadvertently. Temporary Foley catheters were placed by the parents at home. Later, the catheters were electively replaced with permanent catheters in the Radiology suite. One patient was re-admitted for constipation. A high fiber diet and stool softeners solved this problem. Granulation tissue has been seen fairly commonly and this is treated with a progression of saline soaks, hydrogen peroxide soaks, topical calcium carbonate, silver nitrate cauterization, and finally surgical excision as indicated. |