PD358 - RETROGRADE ESOPHAGEAL AND STOMACH TUBING FOR NUTRITION AND PALLIATIVE DRAINAGE: FEASIBILITY AND SAFETY IN A SINGLE-CENTER

PD358

RETROGRADE ESOPHAGEAL AND STOMACH TUBING FOR NUTRITION AND PALLIATIVE DRAINAGE: FEASIBILITY AND SAFETY IN A SINGLE-CENTER

D. Hakimian^1,*, E. Rinott¹, M. Slae²

¹ Gastroentrology, ²Pediatric gastroentrology, hadassah medical center, jerusalem, Israel

Rationale: Severe esophageal outlet dysfunction leads to refractory secretion pooling, aspiration, and significant symptom burden including nutritinal difficulties. 

Methods: We conducted a retrospective single-center case series including six pediatric and adult patients treated between 2022 and 2025. All patients had a pre-existing gastrostomy and symptomatic esophageal obstruction. Using a slim endoscope introduced via the gastrostomy, a guidewire was advanced retrogradely across the esophagogastric junction, and a modified PEG-J tube (with additional side holes in the esophageal segment) was advanced into the distal esophagus; the gastric port was used for feeding or additional drainage, while the jejunal port enabled continuous esophageal drainage

Results: Retrograde esophageal GJ placement was technically successful in all six patients, across a wide age and disease spectrum, with no intra or post-procedural complications, requiring no sedation. The drainage port functioned reliably, allowing intermittent or continuous drainage and removal of nasogastric tubes.

Conclusion: Retrograde transgastric placement of a GJ tube into the esophagus represents a feasible and reproducible strategy that directly integrates decompression with enteral nutrition support in patients with refractory esophageal stasis. It addresses a clinically relevant gap in the nutritional and palliative management of patients with advanced foregut dysfunction.

Disclosure of Interest: None declared