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AJR Am J Roentgenol. 2012 Mar;198(3):W274-8. doi: 10.2214/AJR.11.7109.

A novel method of punctured Miller-Abbott tube placement using a guidewire under fluoroscopic guidance.

Author information

1
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul, Republic of Korea.

Abstract

OBJECTIVE:

The purpose of this article is to evaluate the usefulness of a new technique for placing Miller-Abbott tubes in patients with small-bowel obstruction.

SUBJECTS AND METHODS:

The Miller-Abbott tube was placed in 10 patients by use of the conventional method (group A) and in 11 patients with a punctured Miller-Abbott tube with the use of guidewire (group B). Technical success was defined as insertion of the tube into the duodenum beyond the pylorus of the stomach in group A and into the jejunum beyond the Treitz ligament in group B. Clinical success was defined as intestinal decompression and relief of obstructive symptoms. We evaluate the correlations between the cause of obstruction and the end results.

RESULTS:

The success rate of the tube placement was 40% (4/10) in group A and 100% (11/11) in group B. Clinical success of tube placement was achieved in five of 10 patients (50.0%) in group A and in nine of 11 patients (81.8%) in group B. Carcinomatosis was associated with significantly decreased clinical success rates in both groups (p = 0.038 in group A; p = 0.039 in group B). The mean (± SD) procedure time for placement of the Miller-Abbott tube was 35.8 ± 8.13 minutes in group A and 15.3 ± 5.93 minutes in group B, with a statistically significant difference (p < 0.001).

CONCLUSION:

The new technique of placing a punctured Miller-Abbott tube with the use of a guidewire enables the tube to pass through the pylorus and the Treitz ligament while significantly reducing the procedure time, with no clinical disadvantages caused by the puncture site.

PMID:
22358025
DOI:
10.2214/AJR.11.7109
[Indexed for MEDLINE]

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