Indications, complications and long-term follow-up of patients undergoing percutaneous endoscopic gastrostomy: A retrospective study

Ermış, Fatih; Özel, Ahmet; Öncü, Kemal; Yazgan, Yusuf; Demırtürk, Levent; Gürbüz, Ahmet Kemal; Akyol, Taner; Nazik, Hasan

doi:10.1007/s00508-011-0082-0

Cited by 31 publications

(19 citation statements)

References 43 publications

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“…PEG associated complications we observed in 14 patients (18%). 18 In our patient population with similar clinical characteristics, PEG related complications occurred in 15 patients (12%).…”

Section: Discussionmentioning

confidence: 62%

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Outcomes of percutaneous endoscopic gastrostomy in hospitalized patients at a tertiary care center in Turkey

et al. 2014

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BACKGROUND / OBJECTIVESThe aim of this study was to perform a retrospective analysis characterizing patients receiving tube feeding following percutaneous endoscopic gastrostomy ( PEG) tube placement between 2004 and 2012 at Erciyes University Hospital in Turkey.METHODSPatients above the age of 18 years, who required long term enteral tube feeding were studied. All PEGs were performed using the pull-through technique by one experienced endoscopist Demographic, clinical outcomes, and PEG-related complication data were collected.RESULTSOf the 128 subjects studied, 91 were male (71%) and 37 were female (29%). The mean age of this patient population was 54±19 years. The most common reason for PEG tube insertion was inability to consume oral diet due to complications of cerebrovascular disease (CVD; 27%), while cerebral hypoxia, occuring after non-neurological medical disorders, was the second most common indication (23%). A total of 70 patients (55%) had chronic comorbidities, with hypertension the most common (20%). The most common procedure related complication was insertion site bleeding, which occurred in 4 % of patients. Long term complications, during one year were insertion site cellulitis, gastric contents leakage, and peristomal ulceration occurred in 14%, 5%, and 0.5% of patients, respectively. There were no PEG insertion-related mortalities; one-year mortality was unrelated to the indication for PEG tube insertion.CONCLUSIONSPEG tube insertion was a safe method to provide enteral access for nutrition support in this hospitalized patient population.

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“…PEG associated complications we observed in 14 patients (18%). 18 In our patient population with similar clinical characteristics, PEG related complications occurred in 15 patients (12%).…”

Section: Discussionmentioning

confidence: 62%

“…Minor complications include wound infection/cellulitis, gastric contents leakage, bleeding, pneumoperitoneum, device dislodgement, accidental tube removal and tube blockage. 16–18 …”

Section: Introductionmentioning

confidence: 99%

Outcomes of percutaneous endoscopic gastrostomy in hospitalized patients at a tertiary care center in Turkey

et al. 2014

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“…However, the proportion of early death by bleeding after PEG has been reported to be 1% [8], and as such, the possibility of bleeding being caused by pseudoaneurysm rupture cannot be ruled out. Indeed, we experienced the above-described two cases of similar bleeding in a period of only 11 months.…”

Section: Discussionmentioning

confidence: 99%

Pseudoaneurysm developed after percutaneous endoscopic gastrostomy

Shigoka

Maetani

Saito

2013

European Journal of Gastroenterology &Amp; Hepatology

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Percutaneous endoscopic gastrostomy (PEG) is widely performed. However, despite its widespread use, complications often follow and some of them are life-threatening. We report on two patients who developed pseudoaneurysm after PEG and how the bleeding was stemmed by transcatheter arterial embolization. Case 1 is an 84-year-old man. PEG by the pull method using One Step Button 24 Fr was performed. Blood-laced vomiting, followed by hemorrhagic shock was observed on day 21. Pseudoaneurysm less than 10 mm in diameter was observed in the gastroepiploic artery by urgent percutaneous abdominal angiography. A microcatheter was advanced selectively and the affected area was embolized by metallic coils and n-butyl cyanoacrylate. Case 2 is an 89-year-old man. PEG by the pull method using One Step Button 24 Fr was performed. On day 28, bleeding from the gastrostomy portion occurred and the patient went into shock. On urgent percutaneous abdominal angiography, pseudoaneurysm ∼5 mm in diameter was detected in the left gastric artery. A microcatheter was advanced selectively and the affected area was embolized by metallic coils and n-butyl cyanoacrylate. In the present two cases, gastrostomies were created in the anterior wall of the mid body portion as suitable for PEG position, but the bleedings occurred because of pseudoaneurysm formation accompanied by damage to the gastroepiploic or the left gastric artery. Those who perform PEG on a regular basis should be aware of the possibility of pseudoaneurysm as a serious adverse event.

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“…It usually has no clinical significance and raises alarm only if a ruptured viscus is suspected. Pneumoperitoneum is an early (72 hours) complication of PEG insertion [4,5,7,8].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Arrest due to Pneumoperitoneum After PEG Insertion in ALS Patient

Ceylan¹

2016

Ann Clin Anal Med

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ÖzetAmyotrofik lateral skleroz, primer korteks, beyinsapı ve spinal kordda motor nöron dejenerasyonu ile karakterize motor nöron hastalığıdır. Perkütan endoskopik gastrostomi (PEG) çeşitli nedenlerle oral yoldan beslenemeyen ancak gastrointestinal fonksiyonları normal olan hastalarda nütrisyon desteği sağlamak için tercih edilen bir yöntemdir PEG tüpü yerleştirilmesi ilaçlar ve beslenme için güvenilir erişim sağlamak için yutma güçlüğü olan ALS hastalarına önerilmektedir. Biz 63 yaşında disfaji ve PEG sonrası pnömoperitonum gelişen ALS hastasını ve yoğun bakım sü-recini sunduk. PEG bu vakalarda beslenme tedavisi için sıklıkla kullanılmakta fakat pnömoperitoneum gibi nadir komplikasyonlar, yoğun bakımda kalış süresi ve mortalite oranlarını artırabilmektedir. Anahtar KelimelerAmyotrofik Lateral Skleroz; Perkütan Endoskopik Gastrostomi; Pnömoperitoneum; Kardiyak Arrest Abstract Amyotrophic lateral sclerosis (ALS), the most common motor neuron disease, is characterized by motor neuron degeneration in the primary cortex, brainstem, and spinal cord. Percutaneous endoscopic gastrostomy (PEG) is a preferable method of nutritional support in patients with normal gastrointestinal function who cannot be fed orally for various reasons. PEG tube placement is recommended in amyotrophic lateral sclerosis (ALS) patients with dysphagia to provide reliable access for medications and nutrition. We report a case of a 63-year-old man with amyotrophic lateral sclerosis presenting with dysphagia and pneumoperitoneum following percutaneous endoscopic gastrostomy (PEG) placement. We also report on the intensive care period of this patient. PEG is a widely used nutrition therapy in these cases but complications such as pneumoperitoneum result in long term ICU stays and higher mortality rates.

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Indications, complications and long-term follow-up of patients undergoing percutaneous endoscopic gastrostomy: A retrospective study

Abstract: PEG placement is a safe procedure and well-tolerated with a low mortality and complication rate even in older patients who have multiple co-morbidities under adequate precautions.

Cited by 31 publications

References 43 publications

Outcomes of percutaneous endoscopic gastrostomy in hospitalized patients at a tertiary care center in Turkey

Outcomes of percutaneous endoscopic gastrostomy in hospitalized patients at a tertiary care center in Turkey

Pseudoaneurysm developed after percutaneous endoscopic gastrostomy

Cardiac Arrest due to Pneumoperitoneum After PEG Insertion in ALS Patient

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