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feeding gastrostomy
A surgical opening in the stomach through which a person is fed.
Indications:
1) long-term enteral nutrition
2) swallowing disorders
3) impaired small bowel absorption requiring continuous drip
Contraindications:
1) does NOT prevent aspiration of oropharyngeal secretions
2) does not lead to a better or longer life in severely demented patients
3) does not improve survival at the end of life [5]
Procedure:
1) percutaneous endoscopic gastrostomy (PEG)#
2) fluoroscopically placed
a) radiation exposure
b) smaller tubes placed
3) surgically placed
- more invasive, longer recovery times
Complications:
1) aspiration pneumonia*
2) irritation around tube exit site
3) peritoneal leak (peritonitis)
4) balloon migration & obstruction of pylorus
5) GI bleed
6) ileus
7) bowel obstruction
8) bowel perforation
9) diarrhea
10) metabolic disturbances [3]
* most common complication
Radiology:
- abdominal CT with gastrgraphin through the gastrostomy tube if tube displacement is suspected [3]
Management: # feeding may begin 4 hours after insertion
Related
enteral nutrition
General
gastrostomy
References
- nlmpubs.nlm.nih.gov/hstat/ahcpr/
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 479
- Geriatrics Review Syllabus, American Geriatrics Society,
5th edition, 2002-2004
- Geriatric Review Syllabus, 8th edition (GRS8)
Durso SC and Sullivan GN (eds)
American Geriatrics Society, 2013
- Geriatric Review Syllabus, 10th edition (GRS10)
Harper GM, Lyons WL, Potter JF (eds)
American Geriatrics Society, 2019
- Sampson EL, Candy B, Jones L.
Enteral tube feeding for older people with advanced dementia.
Cochrane Database Syst Rev. 2009 Apr 15;(2):CD007209. Review.
PMID: 19370678
- Medical Knowledge Self Assessment Program (MKSAP) 19.
American College of Physicians, Philadelphia 2021