Su1746 Title: Complication Rates of Percutaneous Endoscopic Gastrostomy (PEG) Tube Removal in Children

2014 ◽  
Vol 79 (5) ◽  
pp. AB389
Author(s):  
Maireade E. Mcsweeney ◽  
Jessica B. Kerr ◽  
Amanda J. Deutsch ◽  
Jenifer R. Lightdale
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Complication Rates ◽  
Endoscopic Gastrostomy ◽  
Tube Removal ◽  
Peg Tube

scholarly journals Inadvertent Percutaneous Endoscopic Gastrostomy Tube Placement through the Transverse Colon to the Stomach Causing Intractable Diarrhea: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
David T. Burke ◽  
Andrew I. Geller ◽  
Alexios G. Carayannopoulos ◽  
Richard Goldstein
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Transverse Colon ◽  
Delayed Diagnosis ◽  
Tube Placement ◽  
Common Mechanism ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Tube Removal ◽  
Peg Tube

Background. Among patients with chronic disease, percutaneous endoscopic gastrostomy (PEG) tubes are a common mechanism to deliver enteral feedings to patients unable to feed by mouth. While several cases in the literature describe difficulties with and complications of the initial placement of the PEG, few studies have documented the effects of a delayed diagnosis of a misplaced tube. Methods. This case study reviews the hospitalization of an 82 year old male with an inadvertent placement of a PEG tube through the transverse colon. Photos of the placement in the stomach as well as those of the follow up colonoscopy, and a recording of the episodes of diarrhea during the hospitalization were made. Results. The records of this patient reveal complaints of gastrointestinal distress and diarrhea immediately after placement of the tube. Placement in the stomach was verified by endoscopy, with discovery of the tube only after a follow up colonoscopy. The tube remained in place after this discovery, and was removed weeks after the diarrhea was unsuccessfully treated with antibiotics. After tube removal, the patient recovered well and was sent home.

Comparison of Complications of Percutaneous Endoscopic Versus Surgically Placed Gastrostomy Tubes in 42 Dogs and 52 Cats

2006 ◽  
Vol 42 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Brenda Jo Salinardi ◽  
Kenneth R. Harkin ◽  
Barret J. Bulmer ◽  
James K. Roush
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Complication Rate ◽  
Complication Rates ◽  
Endoscopic Gastrostomy ◽  
Severity Scores ◽  
Gastrostomy Tubes ◽  
Peg Tube

Dogs and cats that had a percutaneous endoscopic gastrostomy (PEG) tube or surgically placed gastrostomy (SPG) tube inserted were retrospectively analyzed to compare complication rates and the severity of complications. Complication rates and severity scores were not significantly different when the PEG tube group was compared to the SPG tube group in either dogs or cats. Only when data from dogs and cats were combined did PEG tubes have a significantly higher complication rate and significantly greater complication severity scores.

Earlier tracheostomy and percutaneous endoscopic gastrostomy in patients with hemorrhagic stroke: associated factors and effects on hospitalization

2020 ◽  
Vol 132 (1) ◽  
pp. 87-93 ◽  
Author(s):  
Matthew R. McCann ◽  
Kevin W. Hatton ◽  
Olga A. Vsevolozhskaya ◽  
Justin F. Fraser
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Hemorrhagic Stroke ◽  
Tube Placement ◽  
Complication Rates ◽  
Data Set ◽  
Early Tracheostomy ◽  
Factors Associated ◽  
Endoscopic Gastrostomy ◽  
Icu Length Of Stay ◽  
Peg Tube

OBJECTIVEExisting literature supports benefits of early tracheostomy and percutaneous endoscopic gastrostomy (PEG) in certain patient populations. The aim of this study was to review tracheostomy and PEG placement data in patients with hemorrhagic stroke in order to identify factors associated with earlier placement and to evaluate outcomes.METHODSThe authors performed a retrospective review of consecutive patients treated for hemorrhagic stroke between June 1, 2011, and June 1, 2015. Data were analyzed by logistic and multiple linear regression.RESULTSOf 240 patients diagnosed with hemorrhagic stroke, 31.25% underwent tracheostomy and 35.83% underwent PEG tube placement. Factors significantly associated with tracheostomy and PEG included the presence of pneumonia on admission and subarachnoid hemorrhage. Earlier tracheostomy was significantly associated with shorter ICU length of stay; earlier tracheostomy and PEG placement were associated with shorter overall hospitalization. Timing of tracheostomy and PEG was not significantly associated with patient survival or the incidence of complications in this population.CONCLUSIONSThis study identified patient risk factors associated with increased likelihood of tracheostomy and PEG in patients with hemorrhagic stroke who were critically ill. Additionally, we found that the timing of tracheostomy was associated with length of ICU stay and overall hospital stay, and that the timing of PEG was associated with overall length of hospitalization. Complication rates related to tracheostomy and PEG in this population were minimal. This retrospective data set supports some benefit to earlier tracheostomy and PEG placement in this population and justifies the need for further prospective study.

A Comparison of Owner Management and Complications in 67 Cats With Esophagostomy and Percutaneous Endoscopic Gastrostomy Feeding Tubes

2003 ◽  
Vol 39 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Lisa M. Ireland ◽  
Ann E. Hohenhaus ◽  
John D. Broussard ◽  
Brenda L. Weissman
Keyword(s):  
Body Weight ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Medical Records ◽  
Complication Rates ◽  
Feeding Tubes ◽  
Endoscopic Gastrostomy ◽  
Specialized Equipment ◽  
Peg Tube

Esophagostomy feeding tubes were placed in 46 cats. Percutaneous endoscopic gastrostomy (PEG) feeding tubes were placed in 21 cats. Owner management and complications and facility of use were evaluated retrospectively by review of medical records and owner survey. Both tube types were equally effective for maintenance of body weight, ease of owner management, and complication rates. All of 12 owners surveyed were comfortable with PEG tube management. Ninety-six percent of 24 owners surveyed were comfortable with esophagostomy tube management. The esophagostomy tube can be placed less invasively, without specialized equipment, making it an excellent alternative to the PEG tube.

How long do percutaneous endoscopic gastrostomy feeding tubes last? A retrospective analysis

2018 ◽  
Vol 94 (1114) ◽  
pp. 469-474 ◽  
Author(s):  
Keith Siau ◽  
Tom Troth ◽  
Elizabeth Gibson ◽  
Anita Dhanda ◽  
Lauren Robinson ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Cox Regression ◽  
Endoscopic Gastrostomy ◽  
Kaplan Meier ◽  
Peristomal Infection ◽  
Younger Age ◽  
Tube Removal ◽  
Peg Tube

BackgroundPercutaneous endoscopic gastrostomy (PEG) tubes allow for long-term enteral feeding. Disk-retained PEG tubes may be suitable for long-term usage without planned replacement, but data on longevity are limited. We aimed to assess the rates and predictors of PEG longevity and post-PEG mortality.DesignSingle-centred retrospective cohort study of patients with disk-retained (Freka) PEG tubes.MethodsAll patients undergoing PEG between 2010 and 2013 were identified, and retrospective analysis of outcomes until 2017 (median 1062 days) was performed. Time-to-event data were plotted using Kaplan-Meier curves, with predictors of survival derived from multivariate Cox-regression analyses.Results277patients were studied, with a median age of 74 years (IQR 59–82). PEG tube failure occurred in 17.4%, due to: buried bumper syndrome (7.0%), split/broken tube (6.3%), peristomal infection (1.8%) and dislodged tube (1.1%). PEG tube longevity was 95.1% (1 year) and 68.5% (5 year), with age <70 (HR 2.65, 95% CI 1.25 to 5.62, p=0.011) being predictive of PEG failure. Post-PEG mortality was 10.5% (30 day), 35.4% (1 year) and 59.7% (5 year). Age ≥70 was associated with mortality (HR 2.79, 95% CI 1.92 to 4.05, p<0.001), whereas PEG failure (HR 0.46, 95% CI 0.27 to 0.77, p=0.003) and elective PEG removal (HR 0.23, 95% CI 0.08 to 0.64, p=0.005) were associated with reduced mortality.Conclusions68.5% of PEG tubes remain intact after 5 years. Younger age was associated with earlier PEG failure, whereas younger age, PEG replacement and elective PEG tube removal were associated with improved survival. These data may inform future guidance for elective PEG tube replacements.

Bronchoscope-Guided Percutaneous Endoscopic Gastrostomy Tube Placement by Interventional Pulmonologists: A Feasibility and Safety Study

2018 ◽  
Vol 35 (9) ◽  
pp. 851-857 ◽  
Author(s):  
Erik Folch ◽  
Fayez Kheir ◽  
Amit Mahajan ◽  
Daniel Alape ◽  
Omar Ibrahim ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Percutaneous Tracheostomy ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Increased Risk ◽  
Tube Removal ◽  
Gastrostomy Tube Placement ◽  
Peg Tube

Background: Percutaneous endoscopic gastrostomy (PEG) tube placement is a procedure frequently done in the intensive care unit. The use of a traditional endoscope can be difficult in cases of esophageal stenosis and theoretically confers an increased risk of infection due to its complex architecture. We describe a technique using the bronchoscope, which allows navigation through stenotic esophageal lesions and also minimizes the risk of endoscopy-associated infections. Methods: Prospective series of patients who had PEG tube placement guided by a bronchoscope. Procedural outcomes including successful placement, duration of the entire procedure, time needed for passage of the bronchoscope from the oropharynx to the major curvature, PEG tube removal rate, and mortality were collected. Procedural adverse events, including infections and long-term PEG-related complications, were recorded. Results: A total of 84 patients underwent bronchoscope-guided PEG tube placement. Percutaneous endoscopic gastrostomy tube insertion was completed successfully in 82 (97.6%) patients. Percutaneous endoscopic gastrostomy tube placement was performed immediately following percutaneous tracheostomy in 82.1%. Thirty-day mortality and 1-year mortality were 11.9% and 31%, respectively. Overall, minor complications occurred in 2.4% of patients, while there were no major complications. No serious infectious complications were identified and no endoscope-associated hospital acquired infections were documented. Conclusions: The use of the bronchoscope can be safely and effectively used for PEG tube placement. The use of bronchoscope rather than a gastroscope has several advantages, which include the ease of navigating through complex aerodigestive disorders such as strictures and fistulas as well as decreased health-care utilization. In addition, it may have a theoretical advantage of minimizing infections related to complex endoscopes.

Safely replacing a percutaneous endoscopic gastrostomy tube using a portable X-ray system at a patient’s home

2021 ◽  
Vol 14 (1) ◽  
pp. e238462
Author(s):  
Hitoshi Eguchi ◽  
Naoko E Katsuki ◽  
Ken-ichi Yamamoto ◽  
Masaki Tago
Keyword(s):  
Cerebral Infarction ◽  
Medical Care ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Guide Wire ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
X Ray ◽  
Endoscopic Gastrostomy ◽  
Tube Removal ◽  
Home Medical Care ◽  
Peg Tube

An 81-year-old woman who underwent percutaneous endoscopic gastrostomy (PEG) a year before, after cerebral infarction was receiving home medical care. The first accidental PEG tube removal occurred after clinic hours, and the home-care doctor visited her home to quickly reinsert the tube. After the narrowed fistula was dilated, the tube was reinserted with a guide wire. An X-ray taken with a CALNEO Xair, which is an easily portable X-ray system launched in 2018, confirmed that the tip of the PEG tube was successfully placed in the stomach. A similar accidental removal occurred 2 months later, and we managed it in the same way. Both events were resolved with a single radiograph without significant difficulty. With in-home medical care, PEG tube replacement can be performed easily and safely with a handy portable X-ray system.

Treatment of chronic hepatitis C virus infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy tube in a patient with HIV coinfection

2020 ◽  
Vol 78 (1) ◽  
pp. 36-40
Author(s):  
Vanessa Huffman ◽  
Diana C Andrade ◽  
Elizabeth Sherman ◽  
Jianli Niu ◽  
Paula A Eckardt
Keyword(s):  
Case Report ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Fixed Dose ◽  
Pharmacokinetic Data ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Hiv Coinfection ◽  
Peg Tube

Abstract Purpose Ledipasvir/sofosbuvir is an oral combination therapy containing fixed doses of direct-acting antiviral agents indicated for the treatment of hepatitis C virus (HCV) infection. Currently there are limited data on the clinical efficacy of crushed ledipasvir/sofosbuvir administered via feeding tube. Summary This case report discusses the successful treatment of chronic HCV genotype 1b infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy (PEG) tube in a patient with human immunodeficiency virus (HIV) coinfection and high-grade sarcoma who had severe swallowing difficulties. The patient received crushed ledipasvir/sofosbuvir daily for a total of 12 weeks. At 12 weeks the patient had achieved a sustained virologic response. Conclusion Currently, ledipasvir/sofosbuvir is available only as a tablet, with limited pharmacokinetic data available to guide clinicians on use of the fixed-dose combination medication in crushed form. This case report highlights our experience treating a patient with HCV/HIV coinfection through administration of crushed ledipasvir/sofosbuvir via PEG tube, which we found to be a safe and effective therapeutic option.

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