Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple fluoroscopies and images, radiological supervision and interpretation
CPT4 code
Name of the Procedure:
Introduction of long gastrointestinal tube (e.g., Miller-Abbott) with multiple fluoroscopies and images; radiological supervision and interpretation
Common name(s): Nasoenteric tube placement, GI tube placement
Summary
The procedure involves inserting a long gastrointestinal tube, like the Miller-Abbott tube, through the nose and into the stomach or intestines. It uses real-time X-ray imaging (fluoroscopy) and other radiological techniques to ensure correct placement. This helps to address and manage specific gastrointestinal conditions.
Purpose
This procedure is done to relieve bowel obstruction, decompress the stomach or intestines, or facilitate feeding and medication administration in patients who cannot take them orally.
Indications
- Intestinal blockage (e.g., due to tumors or strictures)
- Severe nausea and vomiting
- Gastrointestinal bleeding
- Post-surgical need for intestinal decompression
- Need for temporary enteral feeding
Preparation
- Fasting for several hours before the procedure
- Adjusting regular medications as directed by the healthcare provider
- Undergoing preliminary imaging studies such as X-rays or CT scans
Procedure Description
- The patient is positioned on the fluoroscopy table.
- Local anesthesia may be applied to numb the nasal passage.
- A long gastrointestinal tube (e.g., Miller-Abbott) is gently inserted through the nostril and advanced toward the stomach and intestines.
- Multiple fluoroscopic images are taken to guide and confirm correct placement.
- Radiologists interpret these images to ensure accuracy.
- Adjustments are made as necessary based on real-time imaging feedback.
Tools and equipment: Fluoroscopy machine, GI tube (e.g., Miller-Abbott), local anesthetic Anesthesia: Local anesthetic or light sedation if required
Duration
Typically takes about 30 minutes to 1 hour, depending on the patient's condition and ease of tube placement.
Setting
Performed in a hospital's radiology department or an outpatient clinic equipped with fluoroscopy.
Personnel
- Radiologist
- Radiologic technologist
- Nurse or medical assistant
Risks and Complications
- Discomfort or pain during insertion
- Nasal or throat irritation
- Risk of misplacement into the respiratory tract
- Infection
- Perforation or injury to the gastrointestinal tract
Benefits
- Effective relief of bowel obstruction
- Improved nutritional intake and medication delivery
- Rapid symptom relief, typically within hours
Recovery
- Patients may need to rest for a short period after the procedure.
- Follow-up imaging may be required to ensure continued correct placement.
- Instructions on tube care and monitoring for complications will be provided.
- Normal activities can typically be resumed shortly after the procedure, with some dietary or physical restrictions based on the underlying condition.
Alternatives
- Regular nasogastric tube placement (less effective for deep obstructions)
- Endoscopic methods
- Surgical intervention, depending on the condition
Patient Experience
- Mild discomfort or gagging sensation during insertion
- Possible sore throat or nasal passage post-procedure
- Minimal pain immediately after, with pain management strategies provided
- Constant monitoring for proper tube function and addressing any discomfort that arises