Adverse events associated with percutaneous enteral access

Area of Science:

• Gastroenterology
• Endoscopic Procedures
• Surgical Safety

Background:

• Percutaneous endoscopic gastrostomy (PEG) and jejunostomy (PEJ) are common gastrointestinal procedures.
• While the procedures themselves have low mortality, patient outcomes are often poor due to severe underlying medical conditions.
• These interventions carry risks of post-procedure complications.

Purpose of the Study:

• To review the safety and complication profile of percutaneous endoscopic gastrostomy and jejunostomy placement.
• To highlight the incidence and types of adverse events associated with these enteral feeding procedures.
• To identify gaps in existing guidelines for PEG and PEJ procedures.

Main Methods:

• Review of existing literature and clinical data on percutaneous endoscopic gastrostomy and jejunostomy procedures.
• Analysis of reported periprocedural and postprocedure complications.
• Assessment of current guideline recommendations.

Main Results:

• Percutaneous endoscopic gastrostomy and jejunostomy placement are associated with low periprocedural mortality.
• High overall mortality is primarily attributed to patients' severe underlying diseases.
• Clinically significant complications include infections (tube site, peritonitis), bleeding, and aspiration. Rare events include buried bumpers and visceral injury.

Conclusions:

• Percutaneous endoscopic gastrostomy and jejunostomy are technically safe procedures with low immediate risks.
• The high mortality observed post-procedure is predominantly a reflection of patient comorbidity.
• There is a need for comprehensive guidelines addressing the management and potential complications of these vital procedures.