This is a case series in which 3 infants with gastrojejunostomy tube (GJT) insertion developed delayed perforation secondary to pressure necrosis. A review of all patients who underwent a GJT placement in 2013 was performed. Three of these patients developed surgically confirmed perforation secondary to pressure necrosis during this time period; no patients developed perforation at the time of GJT insertion. The indications for GJT insertion for all 3 patients were severe gastroesophageal reflux disease; 2 patients also had recurrent aspiration. The patients were between 9 weeks and 10 months of age at the time of GJT insertion. The site of perforation for all 3 cases occurred just distal to the ligament of Treitz between 48 and 72 hours following insertion. Given our 3 cases of perforation in patients weighing <10 kg, there may be a higher risk of perforation in low-weight patients.
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