Percutaneous Radiologic Gastrostomy Placement in Challenging Clinical Scenarios

Area of Science:

• Gastroenterology
• Interventional Radiology
• Medical Devices

Background:

• Percutaneous radiologic gastrostomy (PRG) provides essential enteral access for nutrition, medication, and decompression.
• Certain patient comorbidities, including GI obstruction, ascites, and post-surgical anatomy, increase PRG procedural risks.
• Standard PRG techniques may necessitate modifications in these complex cases.

Purpose of the Study:

• To review specific clinical scenarios requiring modified PRG approaches.
• To outline clinical management options for high-risk PRG patients.
• To discuss risk mitigation strategies and present supporting evidence for technical modifications.

Main Methods:

• Literature review of PRG in patients with comorbidities.
• Analysis of technical modifications and deviations from the standard PRG approach.
• Synthesis of clinical management strategies and risk reduction techniques.

Main Results:

• Identified specific patient profiles (e.g., GI obstruction, ascites, postsurgical anatomy) requiring tailored PRG.
• Described various technical modifications and alternative approaches to the standard PRG procedure.
• Highlighted clinical management options and evidence-based risk mitigation strategies.

Conclusions:

• Modified PRG approaches are feasible and necessary for select high-risk patients.
• Careful consideration of patient-specific factors allows for safe and effective PRG.
• This review provides guidance for managing complex PRG cases.