Percutaneous Endoscopic Gastrostomy (PEG)

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  • – If a patient require enteral access for >1 month, a percutaneous tube is preferred, which can be placed endoscopically
  • – Use of prophylactic antibiotic I.V before the procedure is important to prevent periostomal infection

 

Indications of PEG:

  • – Patients who will be unable to consume sufficient nutrition for >1 month despite functional GI tract
  • – Cancer:
  •                 Head, neck cancer
  •                 Malignant bowel obstruction
  • – Stroke
  • – Dementia
  • – Disabling neurological conditions
  •             MND/ALS
  •             MS

Relative contraindications:

  • – Gastric varices
  • – Major gastric resection
  • – Significant disease of the gastric and abdominal wall

– Coagulopathy

Complications of PEG:

  • – Periostomal wound infection (most common complication)
  • – Fever
  • – Ileus
  • – Cutaneous/gastric ulceration
  • – Tube dislodgement or migration proximally or distally within the GI tract
  • – Wound leakage and necrotizing fasciitis
  • – Poor wound healing
  • – Aspiration
  • – Coagulopathy

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