ABSTRACT
Gastrostomy, one of the oldest abdominal operations in continuous use,1 has played an important role in the management of various surgical conditions of the neonate.1-6 The procedure was frequently employed for feeding as well as decompression. Additionally, a combination of gastric drainage with post-pyloric feeding via a jejunal tube was most helpful in the pre-parenteral nutrition era. In the past 3 decades, however, improvement in surgical techniques and postoperative care has led to a more selective use of gastrostomies in patients with major congenital anomalies of the gastrointestinal tract and abdominal wall. On the other hand, there has been an increased utilization of gastrostomies in infants and children without surgical pathology. In most of these, the indication is an inability to swallow, usually secondary to central nervous system impairment. Ironically, often these are patients who have survived because of aggressive neonatal resuscitation and technological advances.
