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Percutaneous endoscopic gastrostomy tube

Pieter Hindryckx, Barbara Dhooghe, Andreas Wannhoff
BACKGROUND:  Buried bumper syndrome (BBS) is a complication of percutaneous endoscopic gastrostomy (PEG) in which the internal bumper is overgrown by the gastric mucosa. Apart from loss of patency of the PEG tube, the buried bumper may evoke symptoms such as abdominal pain or peritubular leakage. While the management of an incompletely buried bumper is fairly straightforward, this is not the case for a completely buried bumper. Different approaches to remove completely buried bumpers have been described, including endoscopic knife- or papillotome-based techniques...
February 13, 2019: Endoscopy
Marian Galovic, Anne Julia Stauber, Natascha Leisi, Werner Krammer, Florian Brugger, Jochen Vehoff, Philipp Balcerak, Anna Müller, Marlise Müller, Jochen Rosenfeld, Alexandros Polymeris, Sebastian Thilemann, Gian Marco De Marchis, Thorsten Niemann, Maren Leifke, Philippe Lyrer, Petra Saladin, Timo Kahles, Krassen Nedeltchev, Hakan Sarikaya, Simon Jung, Urs Fischer, Concetta Manno, Carlo W Cereda, Josemir W Sander, Barbara Tettenborn, Bruno J Weder, Sandro J Stoeckli, Marcel Arnold, Georg Kägi
Importance: Predicting the duration of poststroke dysphagia is important to guide therapeutic decisions. Guidelines recommend nasogastric tube (NGT) feeding if swallowing impairment persists for 7 days or longer and percutaneous endoscopic gastrostomy (PEG) placement if dysphagia does not recover within 30 days, but, to our knowledge, a systematic prediction method does not exist. Objective: To develop and validate a prognostic model predicting swallowing recovery and the need for enteral tube feeding...
February 11, 2019: JAMA Neurology
Hiroko Mori, Mariko Naito, Ayako Nakane, Haruka Tohara
BACKGROUND: Swallowing rehabilitation for patients living with a percutaneous endoscopic gastrostomy (PEG) tube for home enteral nutrition (HEN) is poorly documented, and the quality of caregivers' daily lives is also unknown. METHODS: A qualitative study based on constant comparative analysis was conducted. The study subjects were the caregivers of acquired brain injury survivors residing at home and living with a PEG tube for HEN who had recovered slight oral intake because of swallowing rehabilitation...
February 11, 2019: Nutrition in Clinical Practice
Anna Cavallini, Livio Provenzi, Giunia Scotto Di Minico, Daniela Sacchi, Lidia Gavazzi, Valeria Amorelli, Renato Borgatti
AIM: To assess the predictive validity of the Functional Evaluation of Eating Difficulties Scale (FEEDS) on long-term eating developmental outcomes in infants with neurodevelopmental disorders. METHOD: In total, 144 infants (69 females, 75 males) aged 0 to 12 months (mean [SD] 5.34mo [3.42]) with neurodevelopmental disorders and requiring enteral nutrition support, hospitalized between January 2004 and December 2017, were included. The FEEDS was administered at the onset of hospitalization...
February 5, 2019: Developmental Medicine and Child Neurology
Patrícia Queirós, Diamantino Sousa, Artur Antunes, Mercedez Sanchez, Ricardo França, José Casquilho, Horácio Guerreiro
Gastrostomy site metastization is considered an uncommon complication of percutaneous endoscopic gastrostomy (PEG) placement in patients with head and neck tumours, but it is important to consider this possibility when evaluating gastrostomy-related symptoms. The authors present the case of a 40-year-old male with excessive alcohol consumption and active smoking, diagnosed with a stage IV oropharyngeal squamous cell carcinoma. The patient developed a paraneoplastic demyelinating motor polyneuropathy that, associated with tumour mass effect, caused dysphagia with need for nasogastric tube feeding...
December 2018: GE Portuguese Journal of Gastroenterology
Jacquelin Peck, Kaitlin Sapp, Alexander Wilsey, Michael Wilsey
Buried bumper syndrome is a rare but potentially severe complication of percutaneous endoscopic gastrostomy tube insertion. Though this complication is uncommon, it may lead to pressure necrosis, bleeding, perforation, peritonitis, sepsis, or death. Each case of buried bumper syndrome is unique in terms of patient comorbidities and anatomic positioning of the buried bumper. For this reason, many approaches have been described in the management of buried bumper syndrome. In this case report, we describe the case of an adolescent Caucasian female who developed buried bumper syndrome three years after undergoing percutaneous endoscopic gastrostomy insertion...
January 2019: Pediatric Gastroenterology, Hepatology & Nutrition
R R Song, Y F Tao, C H Zhu, Z B Ju, Y C Guo, Y Ji
Objective: To investigate the effects of nasogastric tube (NGT) and percutaneous endoscopic gastrostomy (PEG) tube feeding on the susceptibility of pulmonary infection in long-term coma patients with stroke or traumatic brain injury. Methods: A total of 295 candidates who were in long-term coma after stroke or traumatic brain injury but without pulmonary infection and eligible for PEG catheterization were screened prospectively between January 2014 and February 2018. The patients were divided into PEG group (86 patients) and NGT group (209 patients) according to the choice of next-of-kin...
December 25, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Gonçalo Nunes, Tânia Meira, Marta Patita, Ana Teresa Barata, Carla Adriana Santos, Jorge Fonseca
BACKGROUND & AIMS: Malnutrition is common in patients eligible for percutaneous endoscopic gastrostomy (PEG). Feeding tube transparietal thickness (TT) may contribute to assess nutritional status. This study aims to: 1) Characterize TT in PEG patients. 2) Determine the association between TT and the currently used tools 3) Define TT best cut-offs to predict undernutrition 4) Assess the correlation between TT and survival. METHODS: Prospective cohort study including patients who underwent PEG...
February 2019: Clinical Nutrition ESPEN
Aniruthan Deivasigamani, Panneerselvam Vinodhini, Thirugnanam Nelson, T P Elamurugan, Sreenath Gs
Percutaneous endoscopic gastrostomy (PEG) is a commonly used minimally invasive procedure to provide safe and durable access for long-term enteral nutrition in patients when oral feeds are not possible. The reported complications of PEG range from minor wound infections to life-threatening complications like hemorrhage and peritonitis. The buried bumper syndrome is one of the uncommon complications with a reported incidence of 0.3 to 2.4%. Though it is considered to be a late complication, the buried bumper syndrome has been reported as early as two weeks following the procedure...
October 29, 2018: Curēus
S Dobos, V Thill, B K Deressa, L Bruyninx, C M Da Silva Costa, E De Koster, E Toussaint
BACKGROUND AND STUDY AIMS: Percutaneous endoscopic gastrostomy is the most common therapeutic procedure performed by the digestive endoscopists in the upper gastrointestinal tract. It aims to feed patients presenting denutrition and/or insufficient oral intake. Percutaneous endoscopic gastrostomy feasibility is about 95-100 % although in some cases it is impossible to achieve it, leading to ask for a surgical placement. Even though the feasibility of the surgical approach is excellent its complications are quite higher than percutaneous endoscopic placement, it requires general anesthesia and sometimes these patients could be non elligible for it due to their comorbidities (malnutrition, cardio-vascular diseases etc...
October 2018: Acta Gastro-enterologica Belgica
Seo Hee Lee, Hee Seok Moon, Jae Ho Park, Ju Seok Kim, Sun Hyung Kang, Eaum Seok Lee, Seok Hyun Kim, Jae Kyu Sung, Byung Seok Lee, Hyun Yong Jeong
Percutaneous endoscopic gastrostomy (PEG) is widely used to provide nutritional support for patients with dysphagia and/or disturbed consciousness preventing oral ingestion, and PEG tube placement is a relatively safe and convenient non-surgical procedure performed under local anesthesia. However, the prevention of PEG-insertion-related complications is important. A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition...
December 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Mary K Montes de Oca, Anthony Nye, Caroline Porter, Justin Collins, Corey Satterfield, Christine M G Schammel, Steven D Trocha
BACKGROUND: Many patients with head and neck cancer (HNC) will require feeding tube placement for nutritional support using percutaneous endoscopic gastrostomy (PEG) tube. Rarely, HNC metastases have been reported at the PEG site, a morbidity associated with a poor outcome. METHODS: Along with a case report, an evaluation of PEG placement methods with metastases from the literature was completed along with a statistical analysis of the literature to determine PEG site metastases and method of placement correlations...
January 7, 2019: Head & Neck
Steven Clayton, Christopher DeClue, Trevor Lewis, Andrea Rodriguez, Kimberly Kolkhorst, Rashid Syed, Ambuj Kumar, Clifford Davis, Patrick Brady
OBJECTIVES: Percutaneous gastrostomy tube placement is performed in patients requiring long-term enteral nutrition. Although both endoscopic and fluoroscopic techniques may be used, there are inherent risks and potential complications associated with both procedures that are not generally known to referring physicians. The purpose of this study was to compare and contrast indications for placement and procedurally related complications between fluoroscopic and endoscopic gastrostomy tubes techniques at a tertiary care facility...
January 2019: Southern Medical Journal
Y Onodera, T Nakano, T Fukutomi, T Naitoh, M Unno, C Shibata, T Kamei
A 58-year-old man who underwent cadaveric kidney transplantation twice presented to hospital with a perforated epiphrenic diverticulum. Computed tomography revealed epiphrenic diverticulitis and right pleural effusion. Upper gastrointestinal fibroscopy showed an epiphrenic diverticulum full of food residue. He was transferred to our hospital, where we performed percutaneous endoscopic gastrostomy under general anesthesia in the supine position before thoracoscopy. Thoracoscopic esophagectomy was performed in the semi-prone position under 6-10 mmHg artificial pneumothorax via the right thoracic cavity...
December 2018: Transplantation Proceedings
Joshua T Halka, Danielle Yee, Andrew Angus, Azmath Mohammed, Shruti Sevak, James Robbins
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a preferred method of long-term enteral nutritional support. Despite its ease of placement, it has a 4% major complication rate, requiring surgical intervention or hospitalization. Early PEG tube dislodgment can cause peritonitis, requiring emergent laparotomy at significant morbidity and cost. T-fasteners have been used as an adjunct gastropexy, but nearly one third migrate into the abdominal wall within the first 2 weeks. We describe a low-cost, minimally invasive technique using widely available surgical instruments to appose the gastric and abdominal walls...
December 18, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Peter Cmorej, Selwan Barbat, Choichi Sugawa
A 65-year-old man with dysphagia underwent placement of a percutaneous endoscopic gastrostomy tube. He was cared for at a nursing facility where the tube became dislodged and was replaced with similar size Foley catheter. Patient was brought to the hospital with dislodged feeding Foley but none was found at the bedside. Diagnostic workup revealed antegrade migration of the catheter into the small bowel. Push enteroscopy was unsuccessful in retrieving the catheter because it was too far distal. Patient was observed for a total of 7 days...
December 18, 2018: BMJ Case Reports
Khaled Bamakhrama, Tahani Ahmed Aldaham, Omar Alassaf
Buried bumper syndrome (BBS) is a relatively rare complication of percutaneous endoscopic gastrostomy (PEG) feeding. In this paper, we report the case of a 74-year-old man who attended the emergency department with bleeding from the PEG tube site that was later confirmed by endoscopy to be BBS. The treatment consisted of a PEG tube replacement with a 10-day course of antibiotics. Furthermore, this report discusses possible signs, symptoms and physical examination signs suggesting BBS. It can cause serious complications that might sometimes be fatal...
December 10, 2018: BMJ Case Reports
Mohamad Emad Abdulrahman, Anas Aji, Mhd Belal Alsabek
BACKGROUND: Most gastric lipomas are small, asymptomatic, and detected as incidental findings on radiologic evaluation or endoscopic examination of the upper gastrointestinal tract. We report a large lipoma which was noticed by its mass effect during a percutaneous endoscopic gastrostomy; the full evaluation prevented an unexplained failed procedure. PRESENTATION: A 65 year old man with a cerebrovascular accident (CVA) suffered from resistant vomiting and severe dysphagia...
2018: International Journal of Surgery Case Reports
Racha T Khalaf, Deanna Green, Ernest K Amankwah, Jacquelin Peck, Vanessa Carr, Neil A Goldenberg, Michael Wilsey
BACKGROUND: Improving nutrition status of patients with cystic fibrosis (CF) has a positive effect on pulmonary function. METHODS: We conducted a retrospective case-control study evaluating the effect of percutaneous endoscopic gastrostomy (PEG) placement on body mass index (BMI) and forced expiratory volume in 1 second percent predicted (FEV1 ) between matched subjects with CF who received PEG (n = 20) and controls who did not (n = 40). RESULTS: We observed that after adjusting for mutation class and baseline BMI, BMI percentile increased per month for those with PEG (0...
November 22, 2018: Nutrition in Clinical Practice
Francesca Vincenzi, Giuseppina De Caro, Federica Gaiani, Fabiola Fornaroli, Roberta Minelli, Gioacchino Leandro, Francesco Di Mario, Gian Luigi De' Angelis
Percutaneous endoscopic gastrostomy (PEG) has become a mainstay in providing enteral access for patients with obstructive head, neck and esophageal tumors. Tumor cell implantation is a rare complication in patients with aerodigestive cancers, who have undergone PEG tube placement. The objective of this review is to determine the incidence and contributing risk factors leading to the implantation of metastases into the abdominal wall following PEG placement. A comprehensive review of the literature in PUBMED (2008-2018) was performed...
December 17, 2018: Acta Bio-medica: Atenei Parmensis
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