Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure)
CPT4 code
Name of the Procedure:
Introduction of Long Gastrointestinal Tube (e.g., Miller-Abbott)
Summary
The introduction of a long gastrointestinal tube, such as the Miller-Abbott tube, involves inserting a specialized tube through the nose or mouth into the stomach and beyond into the intestines. This procedure is used to manage obstructions or other issues in the gastrointestinal tract.
Purpose
This procedure is used to relieve obstructions in the intestines or to decompress the gastrointestinal tract. It aims to alleviate symptoms such as vomiting and abdominal pain or to prepare the intestine for surgery.
Indications
- Intestinal obstruction
- Severe abdominal distension
- Bowel inflammation
- Removal of intestinal contents
- Management of postoperative ileus
Preparation
- Patients may be required to fast for several hours before the procedure.
- Necessary adjustments to current medications will be advised by the physician.
- Diagnostic imaging (e.g., X-ray, CT scan) may be conducted prior to the procedure.
Procedure Description
- The patient's nose or mouth is numbed with a local anesthetic.
- A lubricated long gastrointestinal tube is gently inserted through the nose or mouth and guided down the esophagus into the stomach.
- Using fluoroscopy (real-time X-ray), the tube is advanced beyond the stomach and into the intestines.
- The tube's progress is monitored and adjusted as necessary to ensure proper placement.
- Once positioned correctly, the tube may be used for suction, irrigation, or to introduce medication.
Tools and Equipment:
- Miller-Abbott tube or similar long gastrointestinal tube
- Lubricant
- Local anesthetic
- Fluoroscopy machine
Anesthesia or Sedation:
- Local anesthetic is typically used; sedation may be provided if necessary.
Duration
The procedure usually takes about 30 to 60 minutes.
Setting
This procedure is typically performed in a hospital setting, particularly in an endoscopy suite or radiology department.
Personnel
- Gastroenterologist or surgeon
- Radiologist (if fluoroscopy is used)
- Nurses
- Technician to operate imaging equipment
Risks and Complications
- Discomfort or gagging during insertion
- Nasal or throat irritation
- Misplacement of the tube
- Perforation of the gastrointestinal tract (rare)
- Infection
- Bleeding
Benefits
- Relief from symptoms caused by intestinal obstruction
- Decompression of the gastrointestinal tract
- Prevention of complications from bowel obstructions
- Improved surgical outcomes
Recovery
- Patients may need to remain in bed for a few hours post-procedure.
- Monitoring for any immediate complications.
- Instructions on how to care for the tube if it remains in place.
- Follow-up appointments to monitor progress and tube position.
Alternatives
- Intravenous hydration and observation
- Surgical intervention for severe obstructions
- Medications to stimulate bowel movements
- Endoscopic procedures
Each alternative has its own risk-benefit profile, and the best choice depends on the specific circumstances of the patient.
Patient Experience
- Patients may feel discomfort or gagging during tube insertion.
- Once the tube is in place, there may be a sensation of pressure or mild discomfort in the nose or throat.
- Pain is generally minimal and can be managed with appropriate medication.
- Clear communication and reassurance from healthcare providers can help alleviate anxiety.