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Review article: percutaneous endoscopic gastrostomy in infants and children
T Fröhlich1, M Richter, R Carbon
1Gastroenterology Unit, Children's Hospital, Friedrich-Alexander Universität Erlangen-Nuremberg, Erlangen, Germany.
Insights
Percutaneous endoscopic gastrostomy (PEG) is a safe and effective method for long-term enteral nutrition in children. While generally well-tolerated, ongoing research addresses complications like gastro-oesophageal reflux.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
- Nutritional Support
Background:
- Percutaneous endoscopic gastrostomy (PEG) has been a standard for pediatric long-term enteral feeding for approximately 30 years.
- Extensive clinical experience exists for PEG placement in children.
Purpose of the Study:
- To review current knowledge on the clinical use of PEG in children.
- To discuss associated complications, benefits, and special considerations for PEG in pediatric patients.
Main Methods:
- Literature review focusing on pediatric PEG cases.
- Analysis of complications, gastro-oesophageal reflux, benefits, and parental perceptions.
- Inclusion of clinical experience and expert judgment for recommendations.
Main Results:
- PEG use in pediatrics has grown significantly since 1980, with expanding indications and techniques.
- Improved expertise in managing complications exists, but issues like gastro-oesophageal reflux require further investigation.
- Published data aids in refining PEG procedures for pediatric patients.
Conclusions:
- PEG insertion for enteral nutrition in children and adolescents is efficient and safe, even in infants.
- The technique is associated with a manageable rate of complications.
- PEG offers a viable nutritional support option for pediatric patients.
Background:
Percutaneous endoscopic gastrostomy (PEG) placement is widely accepted in children needing long-term gastrostomy feeding and clinical experience has been accumulated using PEG in children for nearly three decades.
Aim:
To discuss the current knowledge about clinical application of percutaneous endoscopic gastrostomy in children as well as associated complications and special aspects.
Methods:
We reviewed literature on PEG, primarily in children, with a focus on complications, gastro-oesophageal reflux, potential benefits and parental perceptions. In addition to reviewing scientific literature, we considered clinical experience and judgment in developing recommendations for special aspects concerning PEG in children.
Results:
Since its introduction in 1980, the use of PEG in paediatric patients has become widely accepted. With expanded experience, the number of medical conditions for which PEG is indicated, as well as the use of new techniques has increased. Published reports have helped improve expertise in dealing with associated complications; however, several key issues remain unresolved such as the implications of gastro-oesophageal reflux associated with PEG placement.
Conclusions:
Percutaneous endoscopic gastrostomy insertion for enteral nutrition in children and adolescents is an efficient and safe technique, even in small children, and is associated with a tolerable complication rate.
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