Chait Trapdoor Cecostomy Tube

Important information:

• The Chait Trapdoor™ cecostomy tube (Chait tube) can be placed as an initial cecostomy tube or can replace a temporary tube.

• If your child has a Chait tube placed by General Surgery or Urology, it will be the first (initial) tube they receive.

• If your child’s Chait tube is placed by Interventional Radiology (IR), they will have a temporary tube placed first and this will be changed to a Chait tube 6 weeks later.

• The Chait tube is less noticeable than the temporary cecostomy tube. The Chait tube is a square piece of plastic that lies flat against the skin. It has an internal tube that is inserted into the first part of the large bowel, called the cecum. The top part of the tube, known as a trapdoor, opens for access to the internal part of the tube. To give your child an enema, you attach a connector tube to the trap door.

Instructions for caring for a Chait tube:

Clean and check the skin under and around the trapdoor daily. 

1. Gather your supplies:

   • 2 washcloths

   • Soap

   • Water

2. Wash your hands with soap and water for 15 seconds. Dry well.

3. Check the skin under and around the tube. Contact your healthcare team if you see any of the following:

   • Redness.

   • Drainage.

   • Swelling.

   • Granulation tissue. This type of tissue (skin) is dark pink or red and grows out from the stoma. It can bleed and grow.

   • Any cracks in the plastic or hinge of the trapdoor.

   • If tube is getting tight or making indentation marks in skin.

   • Call if your child has pain at the site.

4. Clean skin under and around the Chait tube with a washcloth, soap, and water. Start cleaning from center and work outward in a circular motion.

5. Pat the skin dry under and around the trapdoor with a new, dry washcloth.

Instructions for giving an enema through a Chait trapdoor:

 Give the enema as instructed by your healthcare provider. 

1.  Gather your supplies:

   • Gravity bag with roller clamp

   • Trapdoor connecting tube

   • Hook to hang bag

   • Saline solution

   • Phosphate enema solution or glycerin enema solution as ordered by your doctor

   • 60 mL catheter tipped syringe (if instructed to use) 

2. Wash your hands with soap and water for 15 seconds. Dry well.

3. If using a gravity bag, mix add the enema solution to the enema bag as directed by your doctor. If using a syringe, pull up the recommended type and amount of solution using the 60 mL catheter tipped syringe.

4. Have your child sit on the toilet.

5. If using a gravity bag, hang the bag on a hook in the bathroom.

6. Wash your hands with soap and water for 15 seconds. Dry well.

7. Open the lid of the Trapdoor. Find the metal pin of the Chait connecting tube. Insert the metal pin into the small hole located in the center of the flat plastic piece lying against the skin. Push down. 

8. If using an enema bag, remove cap from tubing on enema bag. Connect the enema bag to the Chait connecting tube. If using a syringe, connect the syringe to the Chait connecting tube.

9. If you have mixed glycerin, phosphate, or other additives to saline, squeeze the enema bag to mix the contents right before giving the solution. Additives will separate from the saline and should be mixed with the saline before giving the solution.

10. Open the clamp on the Chait connecting tube. Open the roller clamp on the enema bag.

11. When the enema bag is empty (or you have given all the solution from the syringe), close the roller clamp on the bag. Close the clamp on the connecting tube.

12. Disconnect the saline bag or syringe.
    Note: Do not throw away the bags or connecting tube. You will wash them and use them again.

13. Close the trapdoor.
    Note: Do not discard the gravity bags or trapdoor connecting tube. You will wash them and use them again.

14. Wash your hands with soap and water. Dry well.

15. Your child should continue to sit on the toilet and wait for the bowel to empty. This takes about 30 to 50 minutes.

16. Massaging the abdomen firmly from left to right may help empty the bowel faster. 

17. Empty the bag and connecting tube of all solution. Fill the bag with 200 mL of warm water. Rinse the bag and connecting tube by allowing the water to run through the tubing. Make sure that all sides of the bag have been rinsed thoroughly. Clear tubing of all water. If needed, you may use a small amount of soap for heavy soiling.

    Illustrations used with permission from Cook Medical Incorporated, Bloomington, Indiana

18. Allow bags and connecting tube to completely air dry before storing. Store with tubing clamp open to prevent mold and mildew.
    Note: Do not use any chemicals such as alcohol or acetone to clean the bags or tube.

Contact your healthcare team if your child has any of the following:

• Fever higher than 101°F.

• Bleeding or swelling at the site.

• Pus leaking at the site.

• Sudden, increased, or severe abdominal pain.

• Enema will not flow into cecostomy tube.

• No bowel movement after the enema is given or if enema fluid does not come out.

• Pain or vomiting with the enema.

• If the tube becomes dislodged or falls out, call your provider immediately.  If unable to reach your provider go to the emergency room.

• Any other concerns.

Division of Gastroenterology, Hepatology and Nutrition

• Call Gastroenterology between 8 a.m. and 4:30 p.m., Monday through Friday at 215-590-3630 and push the prompt to speak to your child’s gastroenterologist.

• At all other times call 215-590-1000 and ask to speak to the gastroenterology (GI) fellow on call. 

Division of Pediatric General, Thoracic and Fetal Surgery
Call the surgery clinic at 215-590-2730 and ask to speak to one of the nurse practitioners. 

Division of Urology
Call the Urology clinic at 215-590-2754 and ask to speak to your child’s provider. 

Spina Bifida Program
Call Spina Bifida Program at 215-590-1760 and ask to speak to Spina Bifida Program nurse. 

Reviewed February 2025 by Danielle Karasko, PhD, MSN, CRNP-AC