[Transnasally placed percutaneous endoscopic gastrostomy probe]

A 78-year-old woman in an organic psychotic state with food refusal was referred for a percutaneous endoscopic gastrostomy (PEG), repeated fluid infusions at home having failed to deal with dehydration severe enough to cause coma. She was somnolent on admission; neither a history nor cooperation was obtainable.

Despite premedication with 20 mg diazepam and 100 mg pethidine endoscopy could not be performed through the mouth. A routine gastroscope (9 mm external diameter), however, could be passed transnasally into the stomach without difficulty and the PEG tube also placed transnasally.

When endoscopic access to the stomach via the mouth fails, introduction via the nose is a possible alternative.