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How to avoid complications during percutaneous endoscopic gastrostomy
S W Beasley1, A G Catto-Smith, P M Davidson
1Department of General Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Percutaneous endoscopic gastrostomy (PEG) is a common procedure for children, but technical issues can arise during insertion. This report details potential problems and offers strategies to minimize complications like esophageal injury and colonic perforation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Endoscopy
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a widely accepted method for enteral feeding in pediatric patients.
- Compared to open gastrostomy, PEG offers several advantages, making it a preferred technique.
Purpose of the Study:
- To identify potential technical problems encountered during pediatric PEG insertion.
- To propose preventative measures to reduce the likelihood of these complications.
Main Methods:
- Review of known complications associated with PEG insertion in children.
- Analysis of factors contributing to technical difficulties during the procedure.
Main Results:
- Common complications include esophageal injury, colonic perforation, and wound infections.
- Gastric erosion by the tube and symptomatic gastroesophageal reflux are also recognized issues.
- Fundoplication may be required later to correct reflux.
Conclusions:
- Awareness of potential technical problems is crucial for successful pediatric PEG placement.
- Implementing specific precautions can significantly decrease the incidence of major complications.
- Careful technique and monitoring are essential for patient safety and optimal outcomes.
Abstract:
Percutaneous endoscopic gastrostomy (PEG) has advantages over open gastrostomy, and is an accepted technique for children. However, a number of technical problems may be encountered during insertion. This report identifies those problems and proposes precautions that can be taken to reduce their likelihood. Recognized major complications include esophageal injury, colonic perforation, wound infection, gastric erosion by the gastrostomy tube, and later symptomatic gastroesophageal reflux requiring correction by fundoplication.