Gastric lavage: Procedure, Technique, Indications and Complications

Gastric lavage, also commonly called stomach pumping or gastric irrigation.

It is the process of cleaning the contents of the stomach. It has been used for more than 200 years as a means of eliminating stomach poisons. To do this, a tube is inserted and through this irrigates a liquid that is then extracted to remove all the material or substances from the stomach.

Such devices are normally used in a person who has ingested a poison or an overdose of a drug such as alcohol.

They can also be used before surgery to clear the contents of the digestive tract before it is opened.

Apart from toxicology, gastric lavage is sometimes used to confirm bleeding levels of the upper gastrointestinal tract.

It can play a role in the evaluation of hematemesis. It can also be used as a cooling method for hyperthermia patients.

Technique

Gastric lavage involves the passage of a tube through the mouth or nose to the stomach, followed by sequential administration and the elimination of small volumes of fluid.

The placement of the catheter in the stomach should be confirmed, either by insufflation of air while listening to the stomach, by the pH testing a small amount of the aspirated stomach contents, or by x-rays. This is to ensure that the tube is not in the lungs.

In adults, small amounts of hot water or saline are administered and, through a siphon effect, is eliminated again.

In children, normal saline is used, since children are at higher risk of developing hyponatremia if washing is done with water.

Due to the possibility of vomiting, a suction device is always at hand in case of pulmonary aspiration of gastric contents.

The washing is repeated until the vomit shows no gastric content. If the patient is unconscious or can not protect his respiratory tract, he should be intubated before washing.

The person should be put to sleep during the operation due to its high risk of discharge and hyponatremia.

Indications of gastric lavage

Gastric lavage is used infrequently in modern intoxications and some authorities have suggested that it is not routinely used, if it ever occurs, intoxication situations.

Washing should only be considered if the amount of toxic ingested is potentially life-threatening and the procedure can be carried out within 60 minutes of ingestion.

Washing is also the initial treatment for duodenal atresia in newborns, a condition in which the small intestine is closed to the stomach, causing food to accumulate in the stomach.

When the body temperature rises above 40 ° C, performing a gastric lavage with ice-cold saline solution can also be a measure of aggressive cooling in a medical emergency.

Complications

Many complications have been reported with this treatment, although serious complications are rare.

The most dangerous risk is aspiration pneumonia, which is more likely to occur if hydrocarbons are ingested in patients without a protected airway.

Other complications include laryngospasm, hypoxia, bradycardia, epistaxis, hyponatremia, hypochloremia, water intoxication, or mechanical injury to the stomach.