scholarly journals Usefulness of semi-solid medical foods administered after percutaneous endoscopic gastrostomy

2021 ◽  
Vol 22 (2) ◽  
pp. 130-133
Author(s):  
Yusaku Kajihara
Keyword(s):  
Enteral Nutrition ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Gastrointestinal Symptoms ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Elemental Diets ◽  
Medical Foods ◽  
Semi Solid ◽  
Peg Tube ◽  
Attending Physician

Background: Even if preoperative enteral nutrition is administered without any issues, some patients suffer from gastrointestinal symptoms (e.g., vomiting and diarrhea) after initiating gastrostomy feeding. Because of the amino acid composition and limited amount of lipids, elemental diets may reduce the risk of gastrointestinal symptoms. However, elemental diets are expensive. Semi-solid medical foods are inexpensive and more closely mimic normal physiology than elemental diets. The aim of the present study was to investigate the usefulness of semi-solid medical foods when administered after percutaneous endoscopic gastrostomy (PEG).Method: This retrospective study analyzed 91 patients who had PEG performed by the author who was the attending physician. All patients received preoperative enteral nutrition with liquid nutrients, and there were no instances of gastrointestinal symptoms before PEG tube placement. The types of nutrients administered after PEG were divided into three categories: semi-solid medical foods (n = 20), polymeric formulas (n = 26), and elemental diets (n = 45). The incidence of gastrointestinal symptoms was compared among the three groups.Results: No gastrointestinal symptoms occurred in the semi-solid medical foods group; the incidence of gastrointestinal symptoms in the semi-solid medical foods group was significantly lower than that of the polymeric formulas group [0% vs. 26.9% (7/26), p 0.05] and was similar to that of the elemental diets group [0% vs. 2.2% (1/45), p = 1].Conclusion: If preoperative enteral nutrition is administered without any issues, semi-solid medical foods are useful as nutrients administered after PEG tube placement.

scholarly journals Risk Factors for Gastrointestinal Symptoms post Enteral Nutrition Initiation via a Gastrostomy Tube

2020 ◽  
Vol 21 (3) ◽  
pp. 207-211
Author(s):  
Yusaku Kajihara
Keyword(s):  
Risk Factors ◽  
Enteral Nutrition ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Gastrointestinal Symptoms ◽  
Significant Risk ◽  
Albumin Level ◽  
Tube Placement ◽  
Elemental Diets ◽  
Peg Tube

Background: Percutaneous endoscopic gastrostomy (PEG) facilitates long-term enteral nutrition. However, parenteral nutrition prior to PEG tube placement can cause impaired gastrointestinal function. Additionally, upon initiation of enteral feeding via a PEG tube, some patients suffer from gastrointestinal symptoms (e.g., vomiting, diarrhea), which reduce their quality of life and increase the nursing workload.Method: This retrospective study included 155 patients upon whom the author performed PEG as the attending physician. Enteral nutrition was started through the PEG tube on the third day after its placement. The following characteristics were analyzed: age, gender, indications for PEG, preoperative enteral nutrition, administered liquid nutrients, daily dosage of nutrients, serum albumin levels, serum alanine aminotransferase levels, serum creatinine levels, serum hemoglobin levels, and vomiting or diarrhea within seven days after the initiation of PEG feeding. A logistic regression model was used to identify the risk factors contributing to gastrointestinal symptoms, and three variables were sequentially introduced into the model—preoperative non-enteral nutrition, hypoalbuminemia, and administration of non-elemental diets.Results: Vomiting and diarrhea occurred in 10 and 15 patients, respectively. There were significant differences in administered nutrients and serum albumin levels between patients with and without gastrointestinal symptoms. Multivariate analysis revealed that the adjusted odds ratios for administration of non-elemental diets and serum albumin level ≤3.2 g/dL were 8.05 (95% confidence interval (CI): 2.66–24.4; p 0.001) and 3.81 (95% CI: 1.33–10.9; p 0.05), respectively.Conclusion: The administration of non-elemental diets and a serum albumin level ≤3.2 g/dL were significant risk factors.

scholarly journals Interposed Bowel Loop during Percutaneous Endoscopic Gastrostomy Placement; Rare and Nightmare

2018 ◽  
Vol 09 (03) ◽  
pp. 122-124
Author(s):  
Irfan Ali Shera ◽  
Ram Chandra Soni
Keyword(s):  
Enteral Nutrition ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Tube Placement ◽  
Bowel Loop ◽  
Percutaneous Endoscopic Gastrostomy Placement ◽  
Endoscopic Gastrostomy ◽  
Colocutaneous Fistula ◽  
Peg Tube

Percutaneous endoscopic gastrostomy (PEG) is one of common means of enteral nutrition in day‑to‑day gastroenterology practice. However, PEG is associated with complications such as infection, buried bumper, interposed bowel loops, and colocutaneous fistula. Herein, we present a case of PEG tube placement with interposed bowel loop in the gastric and parietal wall that was managed conservatively.

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.

Safety and efficacy of percutaneous endoscopic gastrostomy tube placement in patients with malignant peritoneal carcinomatosis induced bowel obstruction.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14012-e14012
Author(s):  
Pankaj G Vashi ◽  
Donald Peter Braun ◽  
Brenten Popiel ◽  
Digant Gupta
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Bowel Obstruction ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Insertion Site ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Safety And Efficacy ◽  
Symptom Resolution ◽  
Endoscopic Gastrostomy ◽  
Peg Tube

e14012 Background: Percutaneous Endoscopic Gastrostomy (PEG) tube placement in advanced peritoneal carcinomatosis with bowel obstruction is a feasible palliative procedure to help patients with obstructive symptoms. We describe the safety and efficacy of using PEG tube for decompression in patients with large peritoneal masses. Methods: A consecutive case series of 62 patients (Apr-08 to Jun-11) with advanced abdominal carcinomatosis induced bowel obstruction. All patients were extensively treated for their cancer. None of them were surgical candidates due to extensive peritoneal involvement. All patients had symptoms of nausea, vomiting and pain at the time of PEG tube placement. All patients had a 28F (Bard) PEG tube placed for drainage. The primary outcomes of interest were complications and symptom resolution due to PEG tube placement. Frequency of nausea, vomiting and severity of pain was recorded daily in patient charts. Results: 16 were males and 46 females. The mean age was 50.5 years. Most common cancers were ovary, pancreas, colon and stomach. Of 62 patients, 57 patients had expired at the time of this analysis. Of those 57 expired, 49 had PEG tube at the time of death, while 8 had complete resolution of symptoms with PEG tube removed before death. The 5 out of 62 patients who are alive still have the PEG tube for drainage (average 70.4 days). The average duration of PEG tube placement for all patients combined was 70.9 days (range 6-312 days). Relief of nausea, vomiting and pain was observed in 53 (85.5%), 55 (88.7%) and 35 (56.5%) patients respectively. Of a total of 43 patients who had PEG tube placed for >= 30 days, 24 (56%) could continue with their chemotherapy cycles because of symptom resolution. Non life threatening complications of PEG tube placement were observed in 9 (14.5%) patients. 3 had infection at the insertion site, 2 had bleeding and 3 had leaking at the PEG tube site while 1 had aspiration. 6 (9.7%) patients required replacement of the PEG tube due to occlusion. Conclusions: Placement of PEG tube in presence of advanced peritoneal carcinomatosis is safe and effective in relieving obstructive symptoms as well as extending the period of active cancer therapy.

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.

scholarly journals Buried Bumper Syndrome Revisited: A Rare but Potentially Fatal Complication of PEG Tube Placement

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Saptarshi Biswas ◽  
Sujana Dontukurthy ◽  
Mathew G. Rosenzweig ◽  
Ravi Kothuru ◽  
Sunil Abrol
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Gastric Wall ◽  
Late Complications ◽  
Tube Placement ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Delayed Complications ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Percutaneous endoscopic gastrostomy (PEG) has been used for providing enteral access to patients who require long-term enteral nutrition for years. Although generally considered safe, PEG tube placement can be associated with many immediate and delayed complications. Buried bumper syndrome (BBS) is one of the uncommon and late complications of percutaneous endoscopic gastrostomy (PEG) placement. It occurs when the internal bumper of the PEG tube erodes into the gastric wall and lodges itself between the gastric wall and skin. This can lead to a variety of additional complications such as wound infection, peritonitis, and necrotizing fasciitis. We present here a case of buried bumper syndrome which caused extensive necrosis of the anterior abdominal wall.

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