ABSTRACT
Gastrostomy, one of the oldest abdominal operations in
continuous use,1 has played an important role in the manage-
ment of various surgical conditions of the neonate.17 The
procedure was frequently employed for feeding as well as
intestinal 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 four decades, however, improvement in surgical techni-
ques 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,
these are often patients who have survived because of
aggressive neonatal resuscitation and technological advances.
