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Early accidental dislodgement of PEG tubes
J B Marshall1, G Bodnarchuk, J S Barthel
1Division of Gastroenterology, University of Missouri School of Medicine, Columbia 65212.
Journal of Clinical Gastroenterology
|April 1, 1994
Summary
Accidental dislodgement of percutaneous endoscopic gastrostomy (PEG) tubes can occur. Early removal requires careful management, often involving a delay before reinsertion to prevent serious complications like peritonitis.
Area of Science:
- Gastroenterology
- Medical Devices
- Patient Safety
Background:
- Percutaneous endoscopic gastrostomy (PEG) tubes are common for enteral feeding.
- Newer PEG tube designs with soft internal bolsters may increase risks of dislodgement.
Observation:
- Accidental dislodgement of PEG tubes can happen, especially with newer designs.
- Early dislodgement before fistula maturation poses significant risks, including peritonitis from improper reinsertion.
Findings:
- Management of early PEG tube dislodgement involves nasogastric suction, antibiotics, and observation.
- Delayed endoscopic reinsertion (7-9 days) is a safe approach after early dislodgement.
- A case of peritonitis highlights the dangers of blind reinsertion into an immature tract.
Implications:
- Highlights the importance of careful management protocols for early PEG tube dislodgement.
- Emphasizes the need for delayed reinsertion to ensure fistula maturity and patient safety.
- Informs clinical practice regarding the prevention and management of PEG tube complications.