endoscopic gastrostomy
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2022 ◽  
Author(s):  
Shima Raeesi ◽  
Rezvan Hashemi ◽  
Zahra Vahabi ◽  
Mina Abdolahi ◽  
Mohsen Sedighiyan

Dementia is a progressive, disabling neurogenic disease that results in serious nutritional deficiencies included dysphagia, malnutrition, and weight loss. The Percutaneous Endoscopic Gastrostomy (PEG) is a long-term enteral feeding method that is routinely used in demented patients with poor food intake as a standard protocol. However, most of the pieces of evidence have not shown the beneficial effects of PEG feeding on complications or survival rates in these patients. Some studies have even reported an increase in mortality. The current systematic review and meta-analysis aimed to evaluate the mortality rate and survival in primary demented patients with PEG. A systematic search was conducted on Pubmed and Scopus databases up to Aug 2019. The data were reviewed according to the Cochrane handbook and preferred reporting items for systematic reviews and meta-analyses (PRISMA) and meta-analysis of observational studies in epidemiology (MOOSE). Based on the random-effects model, the mortality rate and median survival were expressed as risk ratio and weighted mean difference (WMD) and 95% CI, respectively. Among 13 included studies, PEG insertion in patients with primary dementia has no significant effect on 30-day, 90-day, 180-day, 1-year, and 2- year mortality rate or median survival (WMD: 9.77; 95% CI: -22.43 to 41.98; P=0.55). It seems that nasogastric tube (NGT) feeding in compared to PEG in this population is more effective. In conclusion, further prospective studies are needed for comprehensive evaluation of mortality or survival regarding comorbidities, underlying disease, cognitive and physical performance, and nutritional problems in demented patients.


2022 ◽  
Vol 2022 ◽  
pp. 1-2
Author(s):  
Celine Aslinia ◽  
Armand Edalati ◽  
Arianna Fallahian ◽  
Arya Edalati ◽  
Maha Hosseini

Gastrostomy tube placement in pregnancy is historically contraindicated due to risk of injury to the developing fetus and exposure to anesthetic agents. However, in cases where oral nutritional access is severely jeopardized, percutaneous endoscopic gastrostomy (PEG) tube placement can be a life-saving measure. In this case report and literature review, we present a case of successful PEG placement in a pregnant woman, followed by a discussion of the existing literature regarding PEG placement during pregnancy.


2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Jun Honda ◽  
Keisuke Kuwana ◽  
Saori Kase ◽  
Shinju Obara ◽  
Satoki Inoue

Abstract Background Pneumoperitoneum is a common complication of percutaneous endoscopic gastrostomy (PEG). We report a case of circulatory and respiratory depression due to pneumoperitoneum caused by PEG dislodgement during endoscopic submucosal dissection (ESD) surgery. Case presentation A 46-year-old man with PEG for dysphagia underwent ESD for esophageal cancer under general anesthesia. The patient developed a gradual increase in peak inspiratory pressure, followed by a decrease in peripheral oxygen saturation (SpO2) and blood pressure, as well as an increase in heart rate (HR) during endoscopic submucosal ESD for esophageal cancer. We suspected mediastinal emphysema due to esophageal perforation, but the surgery was successfully completed. Postoperative computed tomography (CT) revealed that the abdominal and gastric walls, which had been fixed by PEG, were detached, resulting in a large amount of intra-abdominal gas and mediastinal emphysema. Conclusions ESD in patients with PEG should be performed carefully because of the possibility of intraoperative PEG dislodgement and pneumoperitoneum caused by insufflation gas leakage.


2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Shinsuke Yamamoto ◽  
Masanori Nashi ◽  
Keigo Maeda ◽  
Naoki Taniike ◽  
Toshihiko Takenobu

Abstract Background The postoperative complications of mandibular fracture include malocclusion, infection, nonunion, osteomyelitis, and sensorial mental nerve dysfunction. However, there are no reports regarding postoperative dysphagia as a complication of mandibular fracture. Herein, we report a rare case of postoperative dysphagia caused by delayed mandibular fracture treatment in a patient with severe intellectual disability. Case presentation A 46-year-old Japanese male patient with severe intellectual disability fell down and struck his chin. The patient was referred to our department 10 days after the accident. Upon examination, he could not close his mouth because of severe left mandibular body fracture. Open reduction and internal fixation was performed under general anesthesia 16 days after sustaining the injury, and normal occlusion was eventually achieved. However, the patient could not swallow well a day after surgery. He was then diagnosed with postoperative dysphagia caused by disuse atrophy of muscles for swallowing based on videoendoscopic examination findings. Adequate dysphagia rehabilitation could not be facilitated because of the patient’s mental status. Postoperative dysphagia did not improve 21 days after surgery. Therefore, percutaneous endoscopic gastrostomy was required. Conclusions The treatment course of the patient had two important implications. First, postoperative dysphagia caused by disuse atrophy may occur if treatment is delayed in severe mandibular body fracture. Second, in particular, if a patient with severe intellectual disability develops postoperative dysphagia caused by disuse atrophy, adequate dysphagia rehabilitation cannot be facilitated, and percutaneous endoscopic gastrostomy may be required. Therefore, early open reduction and internal fixation is required for mandibular fracture in a patient with severe intellectual disability.


Cureus ◽  
2021 ◽  
Author(s):  
Jobin Philipose ◽  
Dhineshreddy Gurala ◽  
Abhishek D Polavarapu ◽  
Pretty Sara Idiculla ◽  
Vivek Gumaste

2021 ◽  
Vol 6 (3) ◽  
pp. 158-161
Author(s):  
Necattin FIRAT ◽  
Mehmet AZİRET ◽  
Barış MANTOĞLU ◽  
Recayi CAPOGLU ◽  
Hakan DEMİR ◽  
...  

2021 ◽  
Vol 46 ◽  
pp. S737
Author(s):  
A. Piñar-Gutiérrez ◽  
J.L. Pereira-Cunill ◽  
R. Vázquez-Gutiérrez ◽  
P. Serrano-Aguayo ◽  
P. Garrancho-Domínguez ◽  
...  

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