Percutaneous endoscopic gastrostomy

Percutaneous endoscopic gastrostomy (PEG) is a surgical procedure for placing a tube for feeding without having to perform an open operation on the abdomen (laparotomy). It is used in patients who will be unable to take in food by mouth for a prolonged period of time. A gastrostomy, or surgical opening into the stomach, is made through the skin using an endoscope (a flexible, lighted instrument), and a tube is inserted through this opening.

Diagram showing the position of a percutaneous endoscopic gastrostomy (PEG) feeding tube CRUK

Procedure

The PEG procedure is done in a hospital or medical center, and patients are given a local anesthesia, meaning they are awake but do not feel pain. The doctor uses an endoscope to guide the PEG tube through the mouth, esophagus, and stomach, and out through the skin of the abdomen. The procedure takes about 30-45 minutes.

Uses

PEG is used in adults and children who have difficulty swallowing (dysphagia) or who cannot take enough food by mouth to maintain nutrition. Conditions that might require PEG include stroke, cerebral palsy, Parkinson's disease, head injury, and cancer of the mouth or esophagus.

Risks

As with any surgical procedure, there are risks associated with PEG. These may include infection at the PEG site, aspiration (inhaling food or liquids into the lungs), bleeding, perforation of the stomach, and blockage or dislodgment of the tube.

Aftercare

After the PEG procedure, patients may experience some discomfort and pain at the PEG site. This can be controlled with medication. The PEG site must be kept clean and dry, and patients are usually given specific instructions about how to care for the PEG site and how to use and care for the PEG tube.

See also

• Gastrostomy
• Endoscopy
• Enteral nutrition