Fig. 4. A 84-year-old female patient presenting with malnutrition post roux-en-Y gastric bypass. (A) A 21-gauge Chiba needle was advanced into the gastric remnant then it was subsequently distended with normal saline under ultrasound guidance. (B) 3T fasteners (white arrow) were placed and position was confirmed by computed tomography (CT). (C) A 16 French gastrostomy tube was successfully placed. (D) Contrast injected under fluoroscopy, confirming position of gastric tube within gastric remanence.
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