An evaluation of percutaneous endoscopic gastrostomy feeding in AIDS

1996 ◽  
Vol 7 (2) ◽  
pp. 106-109 ◽  
Author(s):  
S Dowling ◽  
D Kane ◽  
A Chua ◽  
S Keating ◽  
P Flood ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Drug Users ◽  
Intravenous Drug Users ◽  
Lower Serum ◽  
Endoscopic Gastrostomy ◽  
Progressive Weight Loss ◽  
Gag Reflex ◽  
Peg Tube ◽  
Self Administered Questionnaire ◽  
Oesophageal Candidiasis

Between October 1991 and October 1993, 17 AIDS patients (14 intravenous drug users, 3 sexually acquired) were com menced on percutaneous endoscopic gastrostomy (PEG) feeding in St James's Hospital. Indications were progressive weight loss related to severe anorexia (11), persistent oesophageal candidiasis (5) and absence of gag reflex (1). Two patients requested PEG tube rem oval after one week because of cram py abdom inal pain without peritonitis. Five patients died from AIDS related infections within 6 weeks of PEG insertion. Ten patients were followed up for > 2 months (mean 5.2 months, range 2.5-15.5 months). In these 10 patients, 1 patient developed a PEG site infection which responded to topical antibiotics. There were no other complications. There was a significant ( P < 0.001) increase in energy and protein intake at 2 months. Variant degrees of weight gain occurred in all patients (mean 2.6 kg) (P < 0.01). Small but significant increases in other anthropometric variables occurred. Patients who died within 6 weeks of PEG insertion were older, and had a lower serum album in than the group who survived > 2 months (P < 0.01). A self-administered questionnaire demonstrated that the majority of patients found PEG feeding acceptable and preferable to nasogastric (NG) feeding.

scholarly journals Attitude and experience of neurologists towards percutaneous endoscopic gastrostomy: an Egyptian study

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Sherien Farag ◽  
Shady S. Georgy ◽  
Mai Fathy ◽  
Ahmed elSadek ◽  
Khaled O. Abdulghani
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Neurological Diseases ◽  
Public Awareness ◽  
Cerebrovascular Disorders ◽  
Common Symptom ◽  
Nasogastric Feeding ◽  
Endoscopic Gastrostomy ◽  
Intervention Failure ◽  
Self Administered Questionnaire ◽  
Nasogastric Tube Insertion

Abstract Background Dysphagia is a common symptom among various neurological diseases. Guidelines recommend gastrostomy insertion for prolonged dysphagia with lower rate of intervention failure encountered with percutaneous endoscopic gastrostomy (PEG) as compared to nasogastric tube insertion. Methods Neurology consultants only were included and completed a self-administered questionnaire concerning their practice backgrounds and previous experience with PEG feeding during their practice. Results Ninety-eight percent stated that they would recommend PEG for patients with prolonged need of nasogastric feeding. However, only 88% actually referred patients to perform PEG, with the cerebrovascular disorders being the most common cases to be referred. The main barriers the surveyed neurologists faced were family resistance and financial reasons (53.5%). Interestingly, younger neurologists practicing for less than 15 years referred patient to perform PEG significantly more frequent than older ones (p = 0.01). About 18% of our sample confirmed the lack of sufficient knowledge about the benefits of PEG feeding, and only 22% previously attended scientific sessions about the benefits and indications of PEG. Conclusion Based on our study, we recommend that PEG should be more encouraged in indicated neurological cases. Scientific sessions targeting neurologists and public awareness about the benefits of PEG and its relatively infrequent complications are highly demanded.

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.

Early report on percutaneous endoscopic gastrostomy at Owerri, Nigeria

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Christopher Nonso Ekwunife ◽  
Kelechi E. Okonta ◽  
Stephen E. Enendu
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Early Report ◽  
Cross Sectional Study ◽  
Tube Placement ◽  
Safe Procedure ◽  
Cross Sectional ◽  
Endoscopic Gastrostomy ◽  
Neurologic Disorders ◽  
Superficial Skin ◽  
Peg Tube

Objectives: Percutaneous endoscopic gastrostomy (PEG) is a well-established endoscopic procedure that is used predominantly to create enteral access for feeding. Its use has not been widespread in Nigeria despite its efficacy. This study is done to review the early experiences in the use of PEG in Federal Medical Centre, Owerri and Carez Clinic, Owerri. Material and Methods: This is a 4-year retrospective cross-sectional study of patients who had PEG from January 2015 to December 2018. The indications, complications, and outcomes of the procedure were analyzed. Results: A total of 13 patients had pull-type gastrostomy during this period. Six (46.1%) patients had the procedure on account of neurologic disorders, 4 (30.8%) patients had esophageal tumors, while 3 (23.1%) patients had esophageal motility disorders. The overall success rate for PEG tube placement was 100%. The most common complication was superficial skin infection 30.8% (4/13). No mortality was attributable to the procedure. Conclusion: PEG is still not commonly done in our setting, but it is a relatively safe procedure. Physicians should be encouraged to offer it to our teeming patients with neurologic disorders who may benefit from it.

A novel device for the endoscopic management of buried bumper syndrome

Endoscopy ◽  
2019 ◽  
Vol 51 (07) ◽  
pp. 689-693 ◽  
Author(s):  
Pieter Hindryckx ◽  
Barbara Dhooghe ◽  
Andreas Wannhoff
Keyword(s):  
Abdominal Pain ◽  
Gastric Mucosa ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Endoscopic Management ◽  
First Line ◽  
Off Label ◽  
Novel Device ◽  
Endoscopic Gastrostomy ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Abstract 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. However, these devices are used off-label and the procedures can be laborious. Methods The Flamingo device has recently been introduced as the first tool specifically designed to remove a completely buried bumper. Results We describe the technique and our first experience in five patients with a completely (n = 4) or almost completely (n = 1) buried bumper. Fast and save removal of the buried bumper was obtained in all patients. Conclusion We believe that this device has the potential to become the standard first-line tool for the management of completely buried bumpers.

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