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percutaneous endoscopic gastrostomy (PEG)

Indications: - placement of long-term feeding tube for enteral nutrition Procedure: 1) placed under direct vision 2) rapid recovery Prophylactic antibiotics prior to procedure: - Augmentin (single dose) Replacement PEG: balloon non-balloon Complications: 1) stomal infections 2) intestinal perforation 3) pneumoperitoneum (generally resolves spontaneously) [3] 4) hiatal hernia [3] 5) erosive esophatis [3] 6) feeding-related aspiration pneumonia Management: - enteral nutrition - bolus feedings of semi-solid food may reduce risk for aspiration pneumonia [4]

General

gastrostomy

References

  1. Journal Watch vol 19 #22, pg 174, Nov 15, 1999
  2. Wiesen AJ, Sideridis K, Fernandes A, Hines J, Indaram A, Weinstein L, Davidoff S, Bank S. True incidence and clinical significance of pneumoperitoneum after PEG placement: a prospective study. Gastrointest Endosc. 2006 Dec;64(6):886-9. PMID: 17140892
  3. Nishiwaki S, Araki H, Goto N, Niwa Y, Kubota M, Iwashita M, Onogi N, Hatakeyama H, Hayashi T, Maeda T, Saitoh K. Clinical analysis of gastroesophageal reflux after PEG. Gastrointest Endosc. 2006 Dec;64(6):890-6. PMID: 17140893
  4. Toh Yoon EW, Yoneda K, Nishihara K. Semi-solid feeds may reduce the risk of aspiration pneumonia and shorten postoperative length of stay after percutaneous endoscopic gastrostomy (PEG). Endosc Int Open. 2016 Dec;4(12):E1247-E1251. PMID: 27995184 Free PMC Article https://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-117218
  5. Arora G Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement Technique. Medscape. April 11, 2017 http://emedicine.medscape.com/article/149665-technique