Complications of Percutaneous Endoscopic Gastrostomy

Current microbiology of percutaneous endoscopic gastrostomy tube (PEG tube) insertion site infections in patients with cancer

“…Complications associated with PEG tubes include vomiting/aspiration, leakage, PEG tube site (peristomal) infection, perforation/peritonitis, tube migration, hemorrhage, and abscess formation [3][4][5][6][7]. Despite low procedural morbidity and mortality, local and occasional systemic infection is still a concern with reported rates ranging from 4% to 60% [8,9]. Infection prevention and prompt treatment using appropriate antimicrobial agents is desirable.…”

Outpatient percutaneous endoscopic gastrostomy in selected head and neck cancer patients

“…To our knowledge, this prospective study represents the largest series to date that describes the experience with PEG as an outpatient procedure ( Table 4). Complications of PEG were classified as early (first 15 days) or late (more than 15 days) according to the postprocedure period, and minor (requiring only conservative therapy) or major (often needing further endoscopic therapy or surgical intervention) according to severity [15][16][17][18]. In this study we focused on complications arising in the first 15 days postprocedure, a period in which hospitalization could possibly have an advantage over the outpatient approach.…”

Percutaneous Endoscopic Gastrostomy in Neurological Patients

“…Other such cases have been recorded with one large series reporting this in 2.3% of the cases (Luman et al, 2001). Hemorrhage occurs in up to 2.5% of PEG placements (Larson et al, 1987;Schapiro & Edmundowicz, 1996). During the procedure hemorrhage may be caused by puncture of gastric wall vessels; the most common cause of hemorrhage post-PEG is due to the ulceration of the gastric mucosa underneath the internal bumper when applied in very tight approximation to the mucosa (Potack & Chokhavatia, 2008).…”

“…In most cases, the fistula will close and a second gastrostomy can be performed (Hogan et al, 1986;Potack & Chokhavatia, 2008;Schapiro & Edmundowicz, www.intechopen.com 1996). If obstruction or peritonitis is present or the fistula does not close despite PEG removal, operative takedown of the fistula is necessary (Cappell & Abdullah, 2000;Patwardhan et al, 2004;Potack & Chokhavatia, 2008;Schapiro & Edmundowicz, 1996). Anecdotal reports support the practice of using a fluid-filled syringe attached to the finder needle during PEG placement for reducing the risk of colonic perforation.…”

“…Buried www.intechopen.com bumper is thought to arise from excessive traction on the tube causing it to erode into the gastric wall. The incidence of this complication has lessened with newer tube designs which utilize a softer internal bumper (Schapiro & Edmundowicz, 1996). Treatment involves removing the tube (which may require upper endoscopy), allowing the tract to close while an alternative method of feeding is established, and then placing a new PEG tube in a different location (Horbach et al, 2007).…”