Percutaneous endoscopic gastrostomy (peg)

Percutaneous endoscopic gastrostomy (PEG)

Percutaneous endoscopic gastrostomy (PEG) is a medical procedure in which a tube is passed into a patient's stomach through the abdominal wall, most commonly to provide a means of feeding when oral intake is not adequate. This procedure is often performed under local anesthesia and is guided by an endoscope.

Indications

PEG is typically indicated for patients who have difficulty swallowing (dysphagia) due to conditions such as stroke, neurological disorders, head and neck cancer, or severe gastroesophageal reflux disease (GERD). It is also used in patients with chronic conditions that impair their ability to eat, such as cystic fibrosis or cerebral palsy.

Procedure

The PEG procedure involves the following steps: 1. An endoscope is inserted through the mouth and into the stomach. 2. The abdominal wall is cleaned and a small incision is made. 3. A needle is inserted through the incision and into the stomach, guided by the endoscope. 4. A guidewire is passed through the needle and the endoscope is used to pull the guidewire out through the mouth. 5. The PEG tube is attached to the guidewire and pulled back down through the mouth, esophagus, and into the stomach. 6. The tube is secured in place with an internal and external bumper.

Complications

While PEG is generally considered safe, there are potential complications, including:

• Infection at the insertion site
• Bleeding
• Perforation of the stomach or abdominal wall
• Aspiration pneumonia
• Tube dislodgement or blockage

Aftercare

Post-procedure care includes monitoring for signs of infection, ensuring the tube is properly secured, and providing instructions on how to care for the PEG tube. Patients and caregivers are taught how to clean the tube, administer feedings, and recognize potential complications.

Alternatives

Alternatives to PEG include nasogastric tube (NG tube) feeding, jejunostomy tube placement, and total parenteral nutrition (TPN). The choice of feeding method depends on the patient's condition, prognosis, and preferences.

Related Pages

• Endoscopy
• Gastrostomy
• Nasogastric intubation
• Jejunostomy
• Total parenteral nutrition
• Dysphagia
• Gastroesophageal reflux disease