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Journal articles on the topic 'PEG tube feeding'

Author: Grafiati
Published: 25 June 2021
Last updated: 1 February 2022

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1

Matron, Rosemary Strange, and Murtle Degnan. "PEG tube feeding." Nursing Older People 12, no. 7 (December 1, 2000): 34. http://dx.doi.org/10.7748/nop.12.9.34.s23.

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2

Siau, Keith, Tom Troth, Elizabeth Gibson, Anita Dhanda, Lauren Robinson, and Neil C. Fisher. "How long do percutaneous endoscopic gastrostomy feeding tubes last? A retrospective analysis." Postgraduate Medical Journal 94, no. 1114 (July 24, 2018): 469–74. http://dx.doi.org/10.1136/postgradmedj-2018-135754.

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BackgroundPercutaneous endoscopic gastrostomy (PEG) tubes allow for long-term enteral feeding. Disk-retained PEG tubes may be suitable for long-term usage without planned replacement, but data on longevity are limited. We aimed to assess the rates and predictors of PEG longevity and post-PEG mortality.DesignSingle-centred retrospective cohort study of patients with disk-retained (Freka) PEG tubes.MethodsAll patients undergoing PEG between 2010 and 2013 were identified, and retrospective analysis of outcomes until 2017 (median 1062 days) was performed. Time-to-event data were plotted using Kaplan-Meier curves, with predictors of survival derived from multivariate Cox-regression analyses.Results277patients were studied, with a median age of 74 years (IQR 59–82). PEG tube failure occurred in 17.4%, due to: buried bumper syndrome (7.0%), split/broken tube (6.3%), peristomal infection (1.8%) and dislodged tube (1.1%). PEG tube longevity was 95.1% (1 year) and 68.5% (5 year), with age <70 (HR 2.65, 95% CI 1.25 to 5.62, p=0.011) being predictive of PEG failure. Post-PEG mortality was 10.5% (30 day), 35.4% (1 year) and 59.7% (5 year). Age ≥70 was associated with mortality (HR 2.79, 95% CI 1.92 to 4.05, p<0.001), whereas PEG failure (HR 0.46, 95% CI 0.27 to 0.77, p=0.003) and elective PEG removal (HR 0.23, 95% CI 0.08 to 0.64, p=0.005) were associated with reduced mortality.Conclusions68.5% of PEG tubes remain intact after 5 years. Younger age was associated with earlier PEG failure, whereas younger age, PEG replacement and elective PEG tube removal were associated with improved survival. These data may inform future guidance for elective PEG tube replacements.
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Ireland, Lisa M., Ann E. Hohenhaus, John D. Broussard, and Brenda L. Weissman. "A Comparison of Owner Management and Complications in 67 Cats With Esophagostomy and Percutaneous Endoscopic Gastrostomy Feeding Tubes." Journal of the American Animal Hospital Association 39, no. 3 (May 1, 2003): 241–46. http://dx.doi.org/10.5326/0390241.

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Esophagostomy feeding tubes were placed in 46 cats. Percutaneous endoscopic gastrostomy (PEG) feeding tubes were placed in 21 cats. Owner management and complications and facility of use were evaluated retrospectively by review of medical records and owner survey. Both tube types were equally effective for maintenance of body weight, ease of owner management, and complication rates. All of 12 owners surveyed were comfortable with PEG tube management. Ninety-six percent of 24 owners surveyed were comfortable with esophagostomy tube management. The esophagostomy tube can be placed less invasively, without specialized equipment, making it an excellent alternative to the PEG tube.
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Rustom, I. K., A. Jebreel, M. Tayyab, R. J. A. England, and N. D. Stafford. "Percutaneous endoscopic, radiological and surgical gastrostomy tubes: a comparison study in head and neck cancer patients." Journal of Laryngology & Otology 120, no. 6 (March 13, 2006): 463–66. http://dx.doi.org/10.1017/s0022215106000661.

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A gastrostomy feeding tube has become the most acceptable method for long-term feeding support in patients with head and neck cancer. The aim of this study was to compare the complications of percutaneous endoscopically inserted gastrostomy (PEG) tubes, radiologically inserted gastrostomy (RIG) tubes and surgically inserted gastrostomy (open/laparoscopic) (SUR) tubes in head and neck cancer patients and also to compare the mortality rates of these patients.Seventy-eight head and neck cancer patients underwent gastrostomy tube insertion (40 PEG, 28 RIG and 10 SUR) during the period February 2002 to February 2005. There were no significant demographic differences between the three groups. Thirty-six patients (46 per cent) developed complications, 32 minor and four major. All three groups were similar in their rate of minor complications, with the dislodgement and blockage rate being lowest in the PEG group (p > 0.05). The mortality rate was 4 per cent within 30 days of gastrostomy tube insertion. There were no deaths in the PEG group, two deaths in the RIG group and one in the SUR group. The PEG tube was considered superior to the RIG and SUR gastrostomy tubes, had fewer complications and was safer. Thus, PEG tube insertion is our first choice for head and neck cancer patients.
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5

Beirne, J. Cliff, and Emma J. Woolley. "Percutaneous endoscopic gastrostomy (PEG) tube feeding." Journal of Oral and Maxillofacial Surgery 52, no. 5 (May 1994): 531. http://dx.doi.org/10.1016/0278-2391(94)90385-9.

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6

Chime, Chukwunonso, Ahmed Baiomi, Kishore Kumar, Harish Patel, Anil Dev, and Jasbir Makker. "Endoscopic Repair of Gastrocolic and Colocutaneous Fistulas Complicating Percutaneous Endoscopic Gastrostomy Tube." Case Reports in Gastrointestinal Medicine 2020 (February 11, 2020): 1–4. http://dx.doi.org/10.1155/2020/7262514.

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Percutaneous endoscopic gastrostomy (PEG) tube feeding has become one of the options for supplemental feeding in a selected group of patients. It is a generally safe procedure usually undertaken by a gastroenterologist or a surgeon in most cases but with over 200,000 tubes being placed yearly, there is bound to be complications. Some of the encountered complications include bleeding, site infection, tube migration, and inadvertent creation of fistula. We present our index patient admitted from a long-term care facility for feculent vomiting and fecal material through the PEG tube. Imaging and colonoscopy confirmed the presence of both a gastrocolic and a colocutaneous fistula, both closed endoscopically with an over-the-scope and through-the-scope clips, respectively. Feeding through a nasogastric tube was resumed after 48 hours, and by the second week of admission, the patient was discharged back to the facility after placement of a new PEG tube.
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7

Sánchez-Muñoz, Luis Angel, Hana Silvagni-Gutiérrez, and Iciar Usategui-Martín. "Dementia and feeding problems: PEG feeding tube or not." Medicina Clínica (English Edition) 153, no. 11 (December 2019): e59-e60. http://dx.doi.org/10.1016/j.medcle.2019.01.045.

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8

FONSECA, Jorge, and Carla Adriana SANTOS. "PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH JEJUNAL EXTENSION PLUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG-J PLUS PEG) IN PATIENTS WITH GASTRIC/DUODENAL CANCER OUTLET OBSTRUCTION." Arquivos de Gastroenterologia 52, no. 1 (March 2015): 72–75. http://dx.doi.org/10.1590/s0004-28032015000100015.

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Background Stent palliation is the gold standard for gastric/duodenal cancer outlet obstruction. When stenting is impossible, feeding may be achieved through a gastrojejunostomy (PEG-J), but displacement of jejunal tube is frequent due to manipulation for feeding and drainage. Gastric outlet obstruction results on increased gastroesophageal reflux or extra-tube leakage. In order to reduce the jejunostomy tube manipulation and the gastric residuum, we created a second gastrostomy (PEG) dedicated to gastric drainage, reducing the PEG-J handling. Objective Our aim was evaluating of the usefulness of an added second gastrostomy in a PEG-J patient, for: 1. controlling symptomatic reflux and extra-tube leakage; 2. preventing jejunal tube dislocation. Methods We retrospectively evaluated patients were stent palliation of gastric/duodenal cancer outlet obstruction was not achieved, who were referred and underwent PEG-J. We selected four of these patients who needed a second PEG dedicated to gastric drainage, which was performed a few centimetres apart from the gastrojejunostomy. In order to achieve an efficient gastric drainage and provide the maximum comfort to the patient, the drainage PEG tube could be linked to an ileostomy bag. Results The four PEG-J cancer patients with longer survival developed symptoms associated with an important gastric residuum. After the drainage gastrostomy, symptoms subsided or vanished and there were no jejunal tube dislocations. Conclusions When stenting is not possible in patients with gastric/duodenal outlet obstruction due to cancer growing, feeding PEG-J plus drainage PEG may be an alternative, allowing duodenal/jejunal feeding and gastric drainage with minimal manipulation of the jejunal tube.
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Cmorej, Peter, Matthew Mayuiers, and Choichi Sugawa. "Management of early PEG tube dislodgement: simultaneous endoscopic closure of gastric wall defect and PEG replacement." BMJ Case Reports 12, no. 9 (September 2019): e230728. http://dx.doi.org/10.1136/bcr-2019-230728.

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A 53-year-old man with dysphagia underwent uneventful placement of a percutaneous endoscopic gastrostomy (PEG) tube for long-term enteral feeding access. 11 hours after the procedure, it was discovered that he had accidentally dislodged the feeding tube. On physical examination, he was found to have a benign abdomen without evidence of peritonitis or sepsis. He was observed overnight with serial abdominal examinations and nasogastric decompression. In the morning, he was taken back to the endoscopy suite where endoscopic clips were employed to close the gastric wall defect and a PEG tube was replaced at an adjacent site. The patient was fed 24 hours thereafter and discharged from the hospital 48 hours after the procedure. Early accidental removal of a PEG tube in patients without sepsis or peritonitis can be safely treated with simultaneous endoscopic closure of the gastrotomy and PEG tube replacement, resulting in earlier enteral feeding and shorter hospital stay.
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10

Kishore, Anand. "Gastrocolic fistula as a complication of percutaneous endoscopic gastrostomy (PEG): a case report and review of literature." International Surgery Journal 5, no. 7 (June 25, 2018): 2653. http://dx.doi.org/10.18203/2349-2902.isj20182791.

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Gastrocolic fistula is a rare complication which is seen after percutaneous endoscopic gastrostomy (PEG). It usually manifest as a late complication. Interesting fact is that gastrocolic fistula is formed during the initial insertion of PEG tube itself but goes unrecognized. It becomes evident only when a tube replacement is done or when tube dislodgement occurs. We report a case where gastrocolic fistula was recognized after 1 month of tube feeding. Aim of our case report is to make clinicians aware of this rare condition and to have high clinical suspicion regarding possible complications of PEG even after a long period of uncomplicated feeding.
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11

Alhazmi, Ghadeer, Mroj Alsabri, Shahad Alsuwat, Adnan Al-Zangabi, Abdulaziz Al-Zahrani, and Mohammed Kareemulla Shariff. "Rectal Bleeding after Insertion of a Percutaneous Endoscopic Gastrostomy Tube." Case Reports in Gastroenterology 14, no. 3 (November 30, 2020): 637–43. http://dx.doi.org/10.1159/000510164.

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Iatrogenic injury to an internal organ such as the stomach, colon, small bowel, or liver after percutaneous endoscopic gastrostomy (PEG) tube insertion is a rare complication. We present a case of rectal bleeding due to colon injury during PEG tube placement. This required urgent exploratory laparoscopic surgery with segmental resection of the transverse colon and replacement of the PEG tube. Postoperatively, the patient significantly improved with time and tolerated PEG tube feeding.
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Suh, Chae-ri, Wonkyung Kim, Baik-Lin Eun, and Jung Ok Shim. "Percutaneous Endoscopic Gastrostomy and Nutritional Interventions by the Pediatric Nutritional Support Team Improve the Nutritional Status of Neurologically Impaired Children." Journal of Clinical Medicine 9, no. 10 (October 14, 2020): 3295. http://dx.doi.org/10.3390/jcm9103295.

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Aim: To evaluate the long-term effects of nutritional improvement following percutaneous endoscopic gastrostomy (PEG) tube feeding stratified by previous feeding method and to assess the impact of underlying muscle tone on the outcomes of the nutritional intervention. Methods: Neurologically impaired children who underwent PEG tube insertion and nutritional intervention provided by a pediatric nutritional support team were enrolled. We measured anthropometric variables, laboratory parameters, and nutritional intake at baseline, 6 months after PEG insertion, and the last visit. We evaluated the percent ideal body weight (PIBW), body mass index (BMI)-for-age z-score, and percentiles and calculated the ratios of calorie intake compared to required requirement (CIR) and protein intake compared to recommended requirement (PIR). Results: The PIBW and BMI-for-age z-score improved during the first 6 months (p = 0.003 and p = 0.005, respectively). The CIR (p = 0.015) and PIR (p = 0.004) increased during the study period. The baseline BMI and PIBW of the previous nasogastric tube feeding group were better than those of the oral feeding group (p = 0.02 and p = 0.03, respectively). The BMI-for-age z-score, PIBW, CIR, and PIR improved in the hypertonic group (p = 0.03, 0.02, 0.03, and 0.01, respectively). Conclusion: PEG tube feeding and active nutritional intervention improved the nutritional status of neurologically impaired children immediately after PEG insertion. The nutritional requirements might vary by the muscle tonicity.
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13

Maruyama, Michio, Shohei Iijima, Nobuya Ishibashi, Michio Inukai, Tetsuharu Oriishi, Naruo Kawasaki, Naomi Kurata, et al. "Feasibility of International Proposed Standardized Enteral Connector for Semi-Solid Formula Feeding." Annals of Nutrition and Metabolism 73, no. 3 (2018): 169–76. http://dx.doi.org/10.1159/000492674.

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Background/Aims: The current study was undertaken to assess if the semi-solid formulas could be used with a new ENFit connector with similar force to current percutaneous endoscopic gastrostomy (PEG) tubes. Methods: Experiment 1: We measured the applied pressure (force) needed to compress the syringe containing 7 viscous semi-solid formulas with a 20 Fr PEG tube and low-profile tube through the ENFit connector or the current connector. Experiment 2: This experiment was conducted to evaluate the compression force through 2 connectors in 3 infusion velocity, 7 PEG tube types with 2 semi-solid formulas. Results: Experiment 1: The force needed to compress the syringe through the ENFit connector was higher in 3 semi-solid formulas with a 20 Fr low-profile tube; otherwise, there were no significant differences. Experiment 2: Each formula required a higher force in the ENFit connector in 6 settings out of 21. Conclusions: The ENFit connector will likely not show any remarkable change in the force to administer the semi-solid formula. However, a higher force was required under some conditions in the prototype ENFit connector. Further investigation of sensory test is needed to confirm the feasibility of the ENFit connector for using the semi-solid formulas.
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Saeed, Muhammad Omar, Thomas Fleck, Ashish Awasthi, and Chander Shekhar. "Migrated PEG balloon causing acute pancreatitis." BMJ Case Reports 14, no. 4 (April 2021): e240605. http://dx.doi.org/10.1136/bcr-2020-240605.

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Percutaneous endoscopic gastrostomy (PEG) is a common procedure for an unsafe swallow or inability to maintain oral nutrition. When a PEG tube needs replacement, a balloon gastrostomy tube is usually placed through the same, well formed and mature tract without endoscopy. We present a patient with a rare complication related to the balloon gastrostomy tube, to raise awareness and minimise the risk of this complication in the future. A 67-year-old female patient presented to the emergency department with severe abdominal pain and vomiting. Her gastrostomy feeding tube displaced inwards, up to the feeding-balloon ports complex. After investigations, she was diagnosed with acute pancreatitis. MR cholangiopancreatography (MRCP) confirmed features of this and, interestingly, an inflated gastrostomy balloon could be seen abutting the major and minor ampullae. The patient confirmed that the PEG tube had been changed to a balloon gastrostomy tube some time ago, but the external fixation plate (external bumper) had been loose lately, with the tube repeatedly moving inwards. She admitted that, 1 day before admission, the PEG tube had receded into the stomach and could not be pulled out with a gentle tug. After reviewing the MRCP images, the balloon was deflated, and the tube retracted. Once correctly placed, the balloon was reinflated, and her symptoms improved over the next 2 days.
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Williams, K., N. Samuels, S. Wesely, O. Danner, R. Smith, J. Nguyen, L. R. Matthews, K. Udobi, E. Childs, and R. Sola. "Early vs Late Tube Feeding Initiation after PEG tube Placement: Does Time to Feeding Matter?" Journal of the National Medical Association 112, no. 5 (October 2020): S19. http://dx.doi.org/10.1016/j.jnma.2020.09.047.

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16

Wesley, S., N. Samuels, K. Williams, O. Danner, R. Smith, C. Butler, J. Nguyen, K. Udobi, E. Childs, and R. Sola. "Early versus late tube feeding initiation after PEG tube placement: Does time to feeding matter?" Injury 52, no. 5 (May 2021): 1198–203. http://dx.doi.org/10.1016/j.injury.2021.03.002.

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Nishiguchi, Yukio, Yuichi Fuyuhiro, Jae-To Lee, Soon-Myoung Kang, Mitsuru Baba, Yuichi Arimoto, Kazuhiro Takeuchi, et al. "Percutaneous Endoscopic Gastrostomy, Duodenostomy and Jejunostomy." Diagnostic and Therapeutic Endoscopy 1, no. 1 (January 1, 1994): 37–43. http://dx.doi.org/10.1155/dte.1.37.

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Although enteral feeding by nasal gastric tube is popular for the patients who have a swallowing disability and require long-term nutritional support, but have intact gut, this tube sometimes causes aspiration pneumonia or esophageal ulcer. For these patients, conventional techniques for performance of a feeding gastrostomy made by surgical laparotomy have been used so far. However, these patients are frequently poor anesthetic and operative risks. Percutaneous endoscopic gastrostomy (PEG) which can be accomplished with local anesthesia and without the necessity for laparotomy has become popular in the clinical treatment for these patients. PEG was performed in 31 cases, percutaneous endoscopic duodenostomy (PED) in 1 case, and percutaneous endoscopic jejunostomy (PEJ) in 2 cases. All patients were successfully placed, and no major complication and few minor complications (9%) were experienced in this procedure. After this procedure, some patients could discharge their sputa easily and their pneumonia subsided. PED and PEJ for the patients who had previously received gastrostomy could also be done successfully with great care. Our experience suggests that PEG, PED, and PEJ are rapid, safe, and useful procedures for the patients who have poor anesthetic or poor operative risks.
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Joundi, R., G. Saposnik, R. Martino, J. Fang, J. Porter, and M. Kapral. "P.059 Predictors of gastrostomy tube placement in patients with dysphagia after acute stroke." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 44, S2 (June 2017): S28. http://dx.doi.org/10.1017/cjn.2017.143.

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Background: In patients with acute stroke, nasogastric (NG) tubes are commonly inserted for feeding when dysphagia is identified, and percutaneous endoscopic gastrostomy (PEG) tubes are placed for severe or persistent dysphagia. However, little is known regarding predictors of PEG insertion. Methods: We used the Ontario stroke registry from 2003-2013 to identify baseline characteristics of all patients with NG or PEG tube insertion after stroke. We used multiple logistic regression with backwards selection to determine variables that were independent predictors of PEG tube insertion during admission. Results: 4002 patients with NG and 1903 patients with PEG were included in the analysis. Independent predictors of PEG were: Age (80+ vs. <60; odds ratio [OR] 1.70), past history of stroke (OR 1.17), higher stroke severity (severe vs. mild stroke; OR 1.37), stroke unit admission (OR 1.46), and dysphagia screening (OR 1.52). Factors associated with reduced odds of PEG insertion were: Prior history of peptic ulcer disease (OR 0.70), prior independence (OR 0.78), dementia (OR 0.76), palliative status (OR 0.49), and thrombolysis (OR 0.66). *All p<0.01 Conclusions: The strongest predictors of PEG were older age, higher stroke severity, stroke unit admission and dysphagia screening. Patients with dementia had reduced odds of PEG. Thrombolysis also reduced odds of PEG and may be protective.
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Kang, Seokin, Yuri Kim, Hee Kyong Na, Sun Ju Chung, and Jeong Hoon Lee. "Duodenal Decubitus Ulcer Caused by Percutaneous Endoscopic Transgastric Jejunostomy Tube." Korean Journal of Helicobacter and Upper Gastrointestinal Research 20, no. 4 (December 10, 2020): 324–27. http://dx.doi.org/10.7704/kjhugr.2020.0032.

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Percutaneous endoscopic gastrostomy (PEG) has substituted surgical gastrostomy for long-term enteral nutrition. Percutaneous endoscopic transgastric jejunostomy (PEG-J) entails placing a feeding tube into the jejunum through PEG. Unlike PEG, PEG-J is associated with complications caused by the jejunal extension tube. Herein, we report a rare complication of PEG-J. A 71-year-old woman who underwent PEG-J for the administration of carbidopa-levodopa, complained of epigastric pain, dyspepsia, and weight loss of more than 10% in 2 months. Esophagogastroduodenoscopy revealed a duodenal decubitus ulcer caused by the pressure from the jejunal extension tube. After removal of the PEG-J and a 4-week treatment with a proton pump inhibitor, the ulcer healed and the symptoms resolved.
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Gupta, Ankur, Anil K. Singh, Deepak Goel, Akash N. Gaind, and Shireesh Mittal. "Percutaneous Endoscopic Gastrostomy Tube Placement: A Single Center Experience." Journal of Digestive Endoscopy 10, no. 03 (July 2019): 150–54. http://dx.doi.org/10.1055/s-0039-3401391.

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Abstract Introduction Percutaneous endoscopic gastrostomy (PEG) tube placement is one of the recommended methods for providing enteral feeding in patients with swallowing difficulty and intact gastrointestinal tract. We review our three years of experience pertaining to PEG placement in our hospital. Methods Records of all the patients, who underwent PEG between May 2014 to September 2017, were reviewed and relevant clinical and procedural details were noted. For all the patients, the procedure was conducted under antibiotic prophylaxis, moderate sedation, and local anesthesia. The PEG tube was placed by the “pull up” method. Telephonic follow-up of the patients was carried out after one month of study completion. Results The PEG tube was placed in 73 patients (male 51 [69.9%]; age median [range] 67 [16–91] years). PEG was placed in 42 patients with stroke (57.6%), other neurologic disorders 17 (23.3%), coma due to head injury 5 (6.8%), and terminal malignancy 9 (12.3%). Technical success was achieved in 73 (97%) patients. Eleven procedure-related complications occurred in nine patients (15.5%) including one death due to peritonitis. Of the 57 patients, who could be followed-up after discharge, 41 died of their primary illness after 65 (1–751) days, nine were alive and continuing on PEG tube feed, and in seven PEG was removed because it was not needed. Conclusion PEG is a useful procedure for enteral feeding. Although procedural success is high, it may be accompanied by significant complications.
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Kruchko, David, Natasha Shah, Charles Broy, and Dean Silas. "Percutaneous Endoscopic Jejunostomy Tube Placement for Treatment of Severe Hyperemesis Gravidarum in Pregnancy." Journal of Investigative Medicine High Impact Case Reports 8 (January 2020): 232470962097595. http://dx.doi.org/10.1177/2324709620975954.

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Hyperemesis gravidarum is a common disease. Most patients are effectively treated with conservative measures, but gastric feeding and, rarely, post-pyloric feeding can be necessary. A 27-year-old woman, G3P2002, with a history of refractory hyperemesis in previous pregnancies, required placement of a nasojejunal tube but was removed due to an oropharyngeal ulcer. Endoscopic placement of a percutaneous endoscopic transgastric-jejunostomy (PEG-J) tube caused resolution of her symptoms. Twelve days after placement, the distal tube became dislodged and was endoscopically replaced with hemoclip anchoring in the jejunum. PEG-J tube placement is a safe and effective option for nutritional support in refractory hyperemesis gravidarum.
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Schwartz, Howard I., Robert I. Goldberg, Jamie S. Barkin, Richard S. Phillips, Alan Land, and Melvyn Hecht. "PEG feeding tube migration impaction in the abdominal wall." Gastrointestinal Endoscopy 35, no. 2 (March 1989): 134. http://dx.doi.org/10.1016/s0016-5107(89)72735-8.

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Smith, DA, PO Olson, and KA Mathews. "Nutritional support for rabbits using the percutaneously placed gastrostomy tube: a preliminary study." Journal of the American Animal Hospital Association 33, no. 1 (January 1, 1997): 48–54. http://dx.doi.org/10.5326/15473317-33-1-48.

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A feeding-tube gastrostomy technique used in dogs and cats has been adapted to the rabbit. A detailed description of the percutaneous, incisionless placement of a gastrostomy tube using a gastroscope is presented. Management of the feeding tube and the formulation of a liquid diet for rabbits also are described. The percutaneous endoscopical gastrostomy (PEG) tube was used successfully to administer enteral nutritional support to the rabbit.
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Howard, Caoimhe, William L. Macken, Ann Connolly, Maria Keegan, David Coghlan, and David W. Webb. "Percutaneous endoscopic gastrostomy for refractory epilepsy and medication refusal." Archives of Disease in Childhood 104, no. 7 (March 4, 2019): 690–92. http://dx.doi.org/10.1136/archdischild-2018-315629.

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ObjectiveCurrent guidelines for percutaneous endoscopic gastrostomy (PEG) placement focus largely on maintaining enteral feeding when oral feeding is no longer possible or adequate with an emphasis on nutrition and quality of life (QOL). Previous publications have also alluded to potential benefits in medication adherence, for example, in children with HIV, renal disease and neurodisability. We describe a cohort of children with refractory epilepsy who refused oral medication and in whom PEG tube placement was initiated for the purpose of drug administration.DesignWe identified children from the medical records of two tertiary paediatric units over a 9-year period who had PEG tube placement for administration of antiepileptic drug (AED) therapy and collected demographic and clinical details from chart reviews. We assessed parent-reported changes in seizure control and QOL using a structured questionnaire.ResultsTen patients met the inclusion criteria. All families reported an improvement in ease of administering medications and eight reported a significant improvement in QOL. Nine children had a decrease in seizure frequency (lasting more than 12 months) following PEG tube placement, including two who underwent surgical intervention for their epilepsy during that period. Four had either a decrease in the number of drugs administered or their doses and four went on to receive fluids and nutrition through their tube on a regular basis. Seven reported PEG complications, which did not require removal of the PEG.ConclusionsThis case series of children with resistant epilepsy demonstrates improvement in seizure control and QOL following PEG tube placement for AED administration.
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Vitale, Caroline A., Tad Hiner, Wayne Ury, Cathy Berkman, and Judith C. Ahronheim. "Tube Feeding in Advanced Dementia: An Exploratory Survey of Physician Knowledge." Care Management Journals 7, no. 2 (June 2006): 79–85. http://dx.doi.org/10.1891/cmaj.7.2.79.

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The administration of artificial nutrition by means of a percutaneous endoscopic gastrostomy (PEG) tube in older persons in the advanced stages of dementia is commonplace, yet the treatment is associated with significant treatment burdens and unclear benefits in this population. In addition, there is wide and unexplained geographic variability in the use of PEG in advanced dementia, which may stem partly from physicians’ lack of understanding about its indications, risks, benefits, and effect on quality of life in advanced dementia. This study was a mail survey undertaken to assess physician knowledge regarding tube feeding in advanced dementia and explore whether certification in geriatrics or other physician characteristics are associated with physician knowledge. To assess knowledge about tube feeding, we asked participants to rate the importance of commonly cited, but non–evidence based, indications for tube feeding in advanced dementia, including recurrent aspiration pneumonia, abnormal swallowing evaluations, abnormal nutritional parameters, preventing an uncomfortable death, and others. Discrepancies between physician knowledge and current evidence regarding tube feeding in advanced dementia were found, indicating a need for improved education of primary care physicians in order to ultimately provide better end-of-life care for patients with advanced dementia.
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Isajiw, George. "To PEG or Not to PEG A Case of a Hospice Referral for Vitamin B12 Deficiency." Linacre Quarterly 76, no. 2 (May 2009): 212–17. http://dx.doi.org/10.1179/002436309803889241.

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This case history of a 92-year-old patient with pernicious anemia and Alzheimer's dementia is an example of an inappropriate hospice referral as a result of the unfortunately all-too-common practice of making such referrals based on apparent clinical deterioration of elderly patients without proper physician diagnostic involvement to rule out reversible pathology. It further demonstrates the benefit of home tube feedings utilizing percutaneous gastrostomy in dementia patients with malnutrition due to swallowing dysfunction without aspiration and without evidence of malabsorption syndrome. The prevailing “prejudice” against recognizing the benefits of tube feeding of the non-terminal elderly on the part of both families and clinicians is a “hurdle” that can be overcome with gentle, persistent patient advocacy and a touch of “paternalism” in the face of the “modern” medical-moral culture of equating “substituted judgment” with “absolute autonomy.” This case also demonstrates the need to evaluate each patient on a rational, individual, clinical basis as opposed to blindly applying so-called “evidence-based medicine” in an extremely diverse population of patients labeled with the so-called diagnosis of “terminal Alzheimer's dementia.”
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Patel, Radhika, Mohamed Mutalib, Akhilesh Pradhan, Hannah Wright, and Manasvi Upadhyaya. "Nurse-led service for children with gastrostomies: a 2-year review." British Journal of Nursing 30, no. 8 (April 22, 2021): 462–66. http://dx.doi.org/10.12968/bjon.2021.30.8.462.

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Background: Percutaneous endoscopic gastrostomy (PEG) feeding can provide long-term nutritional support for patients with a functional gastrointestinal system but insufficient oral intake. Some patients, however, may require jejunal feeding, which can be achieved using a PEG tube with jejunal extension (PEG-J). A previous review at a tertiary paediatric hospital revealed poor documentation and a high incidence of buried bumper syndrome (BBS) in children with gastrostomies. Subsequently, a nurse-led service for gastrostomy care was introduced. Aim: To determine the impact of the nurse-led service. Methods: Prospective review, at 1 year and 2 years, following either a PEG or PEG-J insertion. Patient records were reviewed and a telephone survey was conducted. Statistical analysis was performed using Fisher's exact test. Findings: 32 PEG and 6 PEG-J patients were included in this study. There was 100% documentation of provision of care instructions. Average satisfaction with the service was over 8/10. Incidence of BBS was 0% in the PEG group and 17% in the PEG-J group. Of those parents/carers surveyed, 74% wanted additional tube care support via SMS text message. Conclusion: Introduction of a nurse-led service resulted in complete documentation of provision of care and sustained high levels of parental satisfaction. Future care should focus on utilising technological platforms.
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Nelson, Alan M. "PEG feeding tube migration and erosion into the abdominal wall." Gastrointestinal Endoscopy 35, no. 2 (March 1989): 133. http://dx.doi.org/10.1016/s0016-5107(89)72734-6.

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RAAF, JOHN H., MARUTHI MANNEY, EMMANUEL OKAFOR, LAWRENCE GRAY, and VEDANTUM CHARI. "Laparoscopic Placement of a Percutaneous Endoscopic Gastrostomy (PEG) Feeding Tube." Journal of Laparoendoscopic Surgery 3, no. 4 (August 1993): 411–14. http://dx.doi.org/10.1089/lps.1993.3.411.

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Galaski, Amy, Wei Wei Peng, Michelle Ellis, Pauline Darling, Andrew Common, and Emma Tucker. "Gastrostomy Tube Placement by Radiological versus Endoscopic Methods in an Acute Care Setting: A Retrospective Review of Frequency, Indications, Complications and Outcomes." Canadian Journal of Gastroenterology 23, no. 2 (2009): 109–14. http://dx.doi.org/10.1155/2009/801925.

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OBJECTIVES: To describe the current practice of placing gastrostomy tubes (endoscopic and radiological), patient characteristics, indications for enteral support, complications and outcomes over a 13-month period, and explore factors that influenced complications and outcomes. Second, to provide Canadian data regarding feeding tube placement because no current literature reflecting these practices for Canadian hospitals is available.METHODS: Retrospective chart reviews were conducted. Patients who had initial percutaneous endoscopic gastrostomy (PEG) or percutaneous radiological gastrostomy (PRG) tubes inserted for nutritional purposes were included in the study.RESULTS: A total of 136 charts which included 30 PEG and 44 PRG procedures were reviewed. The PRG group was older than the PEG group (mean [± SD] age 68±19 years versus 55±21 years, respectively; P=0.008). Patients in PEG group had longer lengths of hospital stay and more intensive care unit admissions than the PRG group (P=0.029). The main reason for tube insertion was dysphagia/aspiration (PEG [60%] and PRG [77%]). Minor complications were comparable between the two groups (P=0.678). There were three cases of major complications overall. More subjects in the PRG group died (18%) while in hospital than in the PEG group (3%) (P=0.055). No procedure-related deaths occured in either group.CONCLUSIONS: Both methods of tube insertion provided a safe route for nutrition delivery despite a significant cost differential with PEGs costing 44% more than PRGs. Characteristics such as age, presence of ascites and severity of disease influenced the method of insertion despite the lack of current guidelines. Overall, the present study provides new descriptive data in a Canadian context.
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Naganuma, Atsushi, Ayaka Kishi, Yusuke Ogawa, Tomohiro Kudo, Yoshizumi Kitamoto, Tetsushi Ogawa, and Hideto Oishi. "Usefulness of Percutaneous Transesophageal Gastro-Tubing in Patients Receiving Chemoradiotherapy for Advanced Esophageal Cancer: A Case Report." Case Reports in Oncology 12, no. 3 (November 28, 2019): 901–8. http://dx.doi.org/10.1159/000504569.

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Percutaneous endoscopic gastrostomy (PEG) is often performed for nutritional management in advanced esophageal cancer. We here report a patient who initially received enteral nutrition via a nasogastric tube and in whom the subsequent use of percutaneous transesophageal gastro-tubing (PTEG) circumvented the need for a gastrostomy. It is believed that PEG is less painful than a nasogastric tube. However, we selected PTEG because a PEG would have been within the planned irradiation field and there was concern about radiation dermatitis. We were able to administer chemoradiotherapy with sufficient nutrition via an enteral feeding tube via esophagostomy. PTEG is a very useful tool in patients at risk of radiation dermatitis of the abdomen.
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Gedam, Manik C., Yogesh D. Mankar, Devdas S. Samala, Leena Y. Ingale, Lavanya L., and Dhiraj D. Sagrule. "Study of percutaneous endoscopic gastrostomy compared to nasogastric tube feeding in patients requiring prolong enteral nutritional support." International Surgery Journal 7, no. 7 (June 25, 2020): 2201. http://dx.doi.org/10.18203/2349-2902.isj20202821.

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Background: The aims and objectives of this article were to compare the advantages, disadvantages associated with percutaneous endoscopic gastrostomy (PEG) and nasogastric (NG) tube and also to compare complications, to measure the outcomes in terms of hospital stay, mortality and improvement in nutritional status.Methods: In this prospective and interventional study 25 patients were selected in each group on an alternate basis. Study was conducted on cases of traumatic brain injury and cerebrovascular accident patients admitted in Department of General Surgery, IGGMC for a period of November 2013- November 2015 with a need to provide prolonged enteral nutritional support. Each patient was assessed by a dietician and received a standard enteral feeding according to their body weight. The main outcome was measures at 4 weeks were complications (tube dislodgement, aspiration pneumonia, tube blockade and peristomal infections) and nutritional status.Results: The anthropometric parameters (mid arm circumference, biceps skin fold thickness and triceps skin fold thickness) and serum albumin showed a rise in PEG group at 4 weeks when compared to baseline (0 week) whereas they showed a decline in NG group at follow up (4 weeks). The NG group has got higher mortality 4 (17%) when compared to PEG group 2 (7%) due to aspiration pneumonia. Hence, PEG is better tolerated with lesser complications better nutritional support as assessed by the anthropometric parameters at 4 weeks.Conclusions: We conclude that whenever feasible percutaneous endoscopic gastrostomy (PEG) feeding is a choice over nasogastric (NG) feeding in patients requiring long term enteral support.
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Kajihara, Yusaku. "Risk Factors for Gastrointestinal Symptoms post Enteral Nutrition Initiation via a Gastrostomy Tube." Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy 21, no. 3 (December 30, 2020): 207–11. http://dx.doi.org/10.24871/2132020207-211.

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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.
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Chang, Wei-Kuo, Hsin-Hung Huang, Hsuan-Hwai Lin, and Chen-Liang Tsai. "Percutaneous Endoscopic Gastrostomy versus Nasogastric Tube Feeding: Oropharyngeal Dysphagia Increases Risk for Pneumonia Requiring Hospital Admission." Nutrients 11, no. 12 (December 5, 2019): 2969. http://dx.doi.org/10.3390/nu11122969.

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Background: Aspiration pneumonia is the most common cause of death in patients with percutaneous endoscopic gastrostomy (PEG) and nasogastric tube (NGT) feeding. This study aimed to compare PEG versus NGT feeding regarding the risk of pneumonia, according to the severity of pooling secretions in the pharyngolaryngeal region. Methods: Patients were stratified by endoscopic observation of the pooling secretions in the pharyngolaryngeal region: control group (<25% pooling secretions filling the pyriform sinus), pharyngeal group (25–100% pooling secretions filling the pyriform sinus), and laryngeal group (pooling secretions entering the laryngeal vestibule). Demographic data, swallowing level scale score, and pneumonia requiring hospital admission were recorded. Results: Patients with NGT (n = 97) had a significantly higher incidence of pneumonia (episodes/person-years) than those patients with PEG (n = 130) in the pharyngeal group (3.6 ± 1.0 vs. 2.3 ± 2.1, P < 0.001) and the laryngeal group (3.8 ± 0.5 vs. 2.3 ± 2.2 vs, P < 0.001). The risk of pneumonia was significantly higher in patients with NGT than in patients with PEG (adjusted hazard ratio = 2.85, 95% CI: 1.46–4.98, P < 0.001). Cumulative proportion of pneumonia was significantly higher in patients with NGT than with PEG for patients when combining the two groups (pharyngeal + laryngeal groups) (P = 0.035). Conclusion: PEG is a better choice than NGT feeding due to the decrease in risk of pneumonia requiring hospital admission, particularly in patients with abnormal amounts of pooling secretions accumulation in the pyriform sinus or leak into the laryngeal vestibule.
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Asano, Kazunobu, Osamu Tanaka, and Yasunori Muramatsu. "Importance of Percutaneous Endoscopic Gastrostomy (PEG) in Nutritional Management of Patients with Advanced Head and Neck Cancer." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 1116. http://dx.doi.org/10.1093/cdn/nzaa055_001.

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Abstract Objectives Chemoradiotherapy (CRT) is well established treatment for the head and neck cancer. Patients undergoing CRT often have adverse effects, resulting reduced oral intake, weight loss and malnutrition. Body weight is a life prognostic factor. Thus, proper body weight control is essential for treatment completion. From April 2019, we started nutritional management using PEG. After then, we have seen cases in which weight control was better in tube feeding with PEG than with conventional method. In this case study, we present benefit of tube feeding with PEG to maintain body weight in head neck cancer patients underwent CRT. Methods Five subjects underwent CRT for head and neck cancer were selected. The conventional method were provided for subject 1 and 2 (group A). Subject 3, 4, and 5 were underwent tube feeding with PEG (group B). Energy and protein requirements were calculated at admission. The average daily nutritional sufficiency was calculated for subject 1, 2, 3, and 5. Changes in body weight, arm circumference (AC), and calf circumference (CC), and controlling nutritional status (CONUT) scores at admission and at discharge were compared. Results The daily energy and protein intake sufficiency rates in subject 1, 2, 3, and 5 were as follow; 84.8%, 54.6%, 105.4%, and 114.7% for energy intake, and 89.5%, 47.5%, 112.2%, and 122.7% for protein intake. Change in body weight were −13.3% and −17.6% in group A, and −8.7%, −4.9%, and +4.7% in group B. The greater the energy intake sufficiency rate was, the more weight could be maintained. Subject 2 and 3 were weighed several months after discharge. Subject 2 had further weight loss of −11.9%. In contrary, subject 3 gained 13.9% of weight. He gained weight by continuous intake of enough nutrients with PEG. AC were −13.9% and −2.1% in group A, and −13.2%, −0.9% and −1.2% in group B. CC were −3.3% and −7.8% in group A, and 0.3%, −0.7%, and −2.2% in group B. The tube feeding with PEG enabled to provide sufficient nutrients to suppress muscle loss. The pre-treatment CONUT score was ‘normal’ in all subjects. The CONUT score at discharge were ‘light’ for subject 2 and 3, ‘moderate’ for subject 1, 4, and 5. No association between weight loss and the CONUT score was seen in these subjects. Conclusions PEG was suggested to contribute to good weight control and nutritional management in head and neck cancer treatment. Funding Sources Asahi University Hospital.
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Dowling, S., D. Kane, A. Chua, S. Keating, P. Flood, P. W. N. Keeling, and F. M. Mulcahy. "An evaluation of percutaneous endoscopic gastrostomy feeding in AIDS." International Journal of STD & AIDS 7, no. 2 (April 1, 1996): 106–9. http://dx.doi.org/10.1258/0956462961917474.

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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.
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Lenzen, H., TJ Weismüller, M. Bredt, and MJ Bahr. "Gastrointestinal: PEG feeding tube migration into the colon; a late manifestation." Journal of Gastroenterology and Hepatology 27, no. 7 (June 19, 2012): 1254. http://dx.doi.org/10.1111/j.1440-1746.2012.07157.x.

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Ocepek, A., and T. Ademović. "SUN-LB023: Complications of Peg Feeding Tube Placement in the Elderly." Clinical Nutrition 34 (September 2015): S243. http://dx.doi.org/10.1016/s0261-5614(15)30744-5.

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Williams, S. G. J., F. Ashworth, A. McAlweenie, S. Poole, M. E. Hodson, and D. Westaby. "Percutaneous endoscopic gastrostomy feeding in patients with cystic fibrosis." Gut 44, no. 1 (January 1, 1999): 87–90. http://dx.doi.org/10.1136/gut.44.1.87.

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BackgroundMalnutrition is a common management problem in patients with cystic fibrosis (CF). Various approaches to supplemental nutrition by both parenteral and enteral routes have been used.AimTo analyse the efficacy and acceptability of supplemental overnight feeding using a percutaneous endoscopic gastrostomy (PEG) in patients with CF.Patients53 patients with CF (43 adults; age >17 years) with severe pulmonary disease.MethodsThe technical success and complications of PEG insertion were documented together with changes in nutritional and pulmonary status of the cohort.ResultsPEG tubes were successfully inserted in all patients, with immediate complications (respiratory depression) in two (4%) and late complications in 13 (25%). Feeding was well tolerated by 50/51 (98%) of the cohort during a mean (SEM) follow up of 14.5 (2.1) months. The adult cohort had a significant increase in weight and body mass index at six months which was maintained at 12 months. Serum albumin concentration remained stable at six months but had fallen by 12 months, although the differences were not statistically significant. These results were reflected in the paediatric cohort. Pulmonary function in those followed up for one year had apparently stabilised, but the number of admissions to hospital over the year before and the year after PEG did not change. Half of the cohort were accepted for heart-lung/lung transplantation, the improvement in nutritional status being a prerequisite for this.ConclusionSupplemental PEG tube feeding is well tolerated and results in a significant improvement in nutritional status and an apparent stabilisation of pulmonary function in severely malnourished CF patients with advanced pulmonary disease.
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Bamakhrama, Khaled, Tahani Ahmed Aldaham, and Omar Alassaf. "Buried bumper syndrome presenting with bleeding." BMJ Case Reports 11, no. 1 (December 2018): e225876. http://dx.doi.org/10.1136/bcr-2018-225876.

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Buried bumper syndrome (BBS) is a relatively rare complication of percutaneous endoscopic gastrostomy (PEG) feeding. In this paper, we report the case of a 74-year-old man who attended the emergency department with bleeding from the PEG tube site that was later confirmed by endoscopy to be BBS. The treatment consisted of a PEG tube replacement with a 10-day course of antibiotics. Furthermore, this report discusses possible signs, symptoms and physical examination signs suggesting BBS. It can cause serious complications that might sometimes be fatal. Therefore, the diagnosis needs to be done swiftly and the patient treatment to start without delay. BBS should always top the differentials of physicians once suspected.
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Sbeit, Wisam, Anas Kadah, Amir Mari, Mahmud Mahamid, and Tawfik Khoury. "Simple Bedside Predictors of Survival after Percutaneous Gastrostomy Tube Insertion." Canadian Journal of Gastroenterology and Hepatology 2019 (November 16, 2019): 1–6. http://dx.doi.org/10.1155/2019/1532918.

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Background. Percutaneous endoscopic gastrostomy (PEG) tube insertion is an increasingly used minimally invasive method for long-term enteral feeding. Identification of simple predictors for short-term mortality (up to one month) after PEG insertion is of paramount importance. Aim. We aimed to explore a simple noninvasive parameter that would predict survival following PEG insertion. Methods. We performed a retrospective study of all patients who underwent PEG insertion at the Galilee Medical Center from January 1, 2014 to December 30, 2018. We collected simple clinical and laboratory parameters and survival data and looked for predictors of short-term mortality. Results. A total of 272 patients who underwent PEG insertion were included. Sixty-four patients (23.5%) died within one month after PEG insertion compared to 208 patients (76.5%) who survived for more than one month. Univariate analysis revealed several short-term mortality-related predictors, including older age (OR 1.1, P=0.005), ischemic heart disease (OR 2, P=0.0197), higher creatinine level (OR 2.3, P=0.0043), and elevated CRP level and CRP-to-albumin ratio (OR 1.1, P<0.0001; OR 1.0031, P<0.0001, respectively). In multivariate logistic analysis, older age (OR 1.1, P=0.019), higher creatinine level (OR 1.6, P=0.074), and elevated CRP-to-albumin ratio (OR 1.1, P=0.002) remained significant predictors of short-term mortality after PEG insertion with an ROC of 0.7274. Conclusion. We could identify several simple parameters associated with high risk of mortality, and we recommend considering using these parameters in decision-making regarding PEG insertion. Further prospective studies are needed to validate our findings.
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Abe, Keiichi, Ryuko Yamashita, Keiko Kondo, Keiko Takayama, Osamu Yokota, Yoshiki Sato, Mitsumasa Kawai, et al. "Long-Term Survival of Patients Receiving Artificial Nutrition in Japanese Psychiatric Hospitals." Dementia and Geriatric Cognitive Disorders Extra 6, no. 3 (October 7, 2016): 477–85. http://dx.doi.org/10.1159/000448242.

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Background/Aims: Most patients with dementia suffer from dysphagia in the terminal stage of the disease. In Japan, most elderly patients with dysphagia receive either tube feeding or total parenteral nutrition. Methods: In this study, we investigated the factors determining longer survival with artificial nutrition. Various clinical characteristics of 168 inpatients receiving artificial nutrition without oral intake in psychiatric hospitals in Okayama Prefecture, Japan, were evaluated. Results: Multiple logistic regression analysis showed that the duration of artificial nutrition was associated with a percutaneous endoscopic gastrostomy (PEG) tube, diagnosis of mental disorder, low MMSE score, and absence of decubitus. Conclusion: Patients with mental disorders survived longer than those with dementia diseases on artificial nutrition. A PEG tube and good nutrition seem to be important for long-term survival.
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Choksi, Ajay P., Keyur C. Shah, and Harshad K. Parekh. "Direct percutaneous endoscopic jejunostomy performed with gastroscope." Journal of Digestive Endoscopy 04, no. 03 (July 2013): 090–92. http://dx.doi.org/10.4103/0976-5042.129986.

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AbstractWhile percutaneous endoscopic gastrostomy (PEG) is a well-known approach for achieving enteral feeding, direct percutaneous endoscopic jejunostomy (DPEJ) is a technique that allows endoscopic placement of percutaneous/transabdominal feeding tube directly into the jejunum. It offers a non-surgical alternative for postpyloric enteral feeding for long-term nutritional support when gastric feeding is not technically possible or is inappriopriate. Conventionally DPEJ is done with pediatric colonoscope or small bowel enteroscope. Here, we report a case where DPEJ was accomplished with gastroscope.
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McCarter, Timothy L., Stanley C. Condon, Dorothy J. Gibson, Rita C. Aguilar, and Yang K. Chen. "Prospective randomized study of early versus delayed feeding after PEG tube placement." Gastrointestinal Endoscopy 43, no. 4 (April 1996): 354. http://dx.doi.org/10.1016/s0016-5107(96)80255-0.

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Sathesh-Kumar, T., Hazel Rollins, and Sarah Cheslyn-Curtis. "General Paediatric Surgical Provision of Percutaneous Endoscopic Gastrostomy in a District General Hospital – A 12-Year Experience." Annals of The Royal College of Surgeons of England 91, no. 5 (July 2009): 404–9. http://dx.doi.org/10.1308/003588409x391749.

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INTRODUCTION A small, but significant, number of children require long-term nutritional support. The aim of this study was to demonstrate the safety and efficacy of providing a percutaneous endoscopic gastrostomy (PEG) service for children in a district general hospital and to raise awareness of the suitability of the procedure to be performed on paediatric surgery lists in similar hospitals across the UK. PATIENTS AND METHODS A multidisciplinary paediatric nutrition team was established and all children accepted for PEG insertion between 1995 and 2007 were entered onto a database prospectively and are included in this study. PEG tubes were inserted by the standard pull-through technique under general anaesthetic. RESULTS A total of 172 procedures were performed in 76 children. The median age at first tube insertion was 3 years (range, 0.5–18 years). Length of follow-up ranged from 1 month to 12.6 years. Fifty-eight children (76%) had a neurological abnormality, the commonest being cerebral palsy. All but one procedure were performed successfully, of which 63 (37%) were new insertions, 99 change of tube, 4 changed from surgical gastrostomy and 6 from PEG to button gastrostomy. The median hospital stay was 2 days (range, 2–7 days) for new insertions and 1 day for tube changes. There were 10 (6%) early complications within 30 days, the commonest being peritubal infection (6). The 39 late complications included 16 peritubal infection/granulomata, 9 ‘buried bumpers’, 4 worsening of gastro-oesophageal reflux disease, 2 gastrocolic fistulae, 3 gastrocutaneous fistulae and 4 tubal migration. There was no mortality. CONCLUSIONS We have demonstrated that paediatric PEG procedures and continuing management by a supporting team can be successfully and efficiently provided in the district general hospital. It should be possible for the majority of similar hospitals to provide local access and increase the availability of PEG feeding for children.
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Bani Hani, Mohammed N., Abdel Rahman Al Manasra, Hamzeh Daradkah, Farah Bani Hani, and Zeina Bani Hani. "Cutaneous Myiasis Around Gastrostomy (PEG) Tube Insertion Site: The Second Case Report." Clinical Medicine Insights: Case Reports 12 (January 2019): 117954761986900. http://dx.doi.org/10.1177/1179547619869009.

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Background: Myiasis refers to the infestation of live human with 2-winged larvae (maggots). Cutaneous myiasis is the most commonly encountered clinical form. It is divided into 3 main forms: furuncular, creeping (migratory), and wound (traumatic) myiasis. Case report: In this article, we report an extremely rare case of myiasis around percutaneous endoscopic gastrostomy (PEG) tube in a 71-year-old female patient. She had the tube placed for feeding purposes, 8 months prior to her presentation. Family noticed alive worms emerging from skin at the gastrostomy tube insertion site. Patient was treated conservatively with daily dressing with no debridement or use of systemic agents. Conclusions: PEG tube cutaneous myiasis is an extremely rare disease. Conservative management with petroleum-based and sterilizing agents is shown to be efficient to clear the disease in a short period of time.
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Palmer, Sarah Jane. "An overview of enteral feeding in the community." British Journal of Community Nursing 26, no. 1 (January 2, 2021): 26–29. http://dx.doi.org/10.12968/bjcn.2021.26.1.26.

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Enteral feeding in community settings is becoming increasingly common, and this article aims to help nurses and other healthcare professionals to refresh their knowledge of the important concepts in the community-based care of patients receiving enteral nutrition via a percutaneous endoscopic gastrostomy (PEG) tube. The article provides an overview on the management and care of the patient, the basic principles surrounding the equipment used, identifying the wider team and essential communication to bear in mind, as well as the importance of tailoring a care plan to the individual's needs, taking into consideration cognition, mental health, social needs and other factors. The article also covers red flags that may be seen in the community after tube insertion that require immediate medical attention.
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James, Melissa K., Vanessa P. Ho, Simon P. Tiu, Richard J. Tom, Taylor R. Klein, Gloria M. Melnic, and Sebastian D. Schubl. "Low Abdominal Wall Thickness May Predict Percutaneous Endoscopic Gastrostomy Complications." American Surgeon 83, no. 2 (February 2017): 183–90. http://dx.doi.org/10.1177/000313481708300219.

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Although percutaneous endoscopic gastrostomy (PEG) tube placement is a common and safe procedure to provide enteral feeding, some patients develop complications. The aim of this study was to identify risk factors for the development of post-PEG complications. We hypothesized that patients with low albumin, diabetes, higher body mass index (BMI), thicker abdominal walls, or psychomotor agitation would have more complications. A 2-year retrospective review was performed on patients who received a PEG tube at a single institution. Variables collected included age, preoperative albumin, BMI, abdominal wall thickness (AWT), psychomotor agitation, pre-operative diabetes mellitus, and mortality. A total of 91 patients (70.3% male) were identified (mean age 58.7 years, SD 18.6). Seventeen patients (18.7%) had post-PEG complications and the 30-day mortality rate was 14.3 per cent. Mortality was not attributable to tube placement. Patients with complications weighed less (P = 0.005) and had a lower BMI (P = 0.010) than patients without complications. Additionally, patients with complications had significantly lower AWT (P = 0.02), mean AWT was 21.6 mm (SD 7.6) versus 27.6 mm (SD 8.1) in the noncomplication patients. AWT was the only factor independently associated with post-PEG complications (P = 0.047). There was no significant association between complications and mortality. Continued investigation on how to limit post-PEG complications remains imperative. In our population, lower AWT was independently associated with complications. Preoperative measurement of AWT by pre-procedural imaging can potentially be used to predict the risk of post-PEG complications.
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Sznajder, Janusz, Marta Ślefarska-Wasilewska, and Piotr Wójcik. "Nutrition accesses among patients receiving enteral treatment in the home environment." Polish Journal of Surgery 89, no. 5 (October 31, 2017): 6–11. http://dx.doi.org/10.5604/01.3001.0010.5247.

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Enteral feeding in the home environment is connected with creating access to digestive tract, and thanks to that, this kind of treatment is possible. The gold standard in enteral nutrition is PEG, other types of access are: nasogastric tube, gastronomy and jejunostomy. In the article 851 patients who were treated nutritionally in the home environment, in the nutrition clinic, Nutrimed Górny Śląsk, were analyzed. It was described how, in practice, the schedule of nutrition access looks like in the nutrition clinic at a time of qualifying patients to the treatment (PEG 47,35%, gastronomy 18,91%, nasogastric tube 17,39%,jejunostomy 16,33%) and how it changes among patients treated in the nutrition clinic during specific period of time – to the treatment there were qualified patients with at least three-month period of therapy ( second evaluation: PEG 37,01%, gastrostomy 31,13%, nasogastric tube 16,98%, jejunostomy 15,86%). The structure of changes was described, also the routine and the place in what exchanging or changing nutrition access was analyzed. Conclusions: The biggest changes in quantity, among all groups of ill people concerned patients with PEG and gastronomy. In most cases the intervention connected with exchanging access to the digestive tract could be implemented at patient’s home.
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Cardin, Fabrizio. "Special Considerations for Endoscopists on PEG Indications in Older Patients." ISRN Gastroenterology 2012 (November 25, 2012): 1–12. http://dx.doi.org/10.5402/2012/607149.

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Abstract:
Undernutrition in frail elderly people is a pathological condition that needs to be recognized and addressed early. Neurological dysphagia is among the most frequent causes of this condition in the elderly but should be considered a terminal event in Alzheimer-type dementias. Tube feeding is an important resource for facilitating metabolic recovery in cachectic patients and is particularly successful in “bridging” and stabilizing therapies prior to major treatment able to cure the patient. Clinical management of tube feeding in “incurable” conditions is complex and becomes part of the palliative care and comfort provided in the terminal stages of illness. Non-specialized physicians are often unfamiliar with the theory and practice of end-of-life interventions, and the resulting decisions are in many cases actually contrary to patient comfort. These problems deserve to be more carefully addressed when the patient is unable to cooperate or express his/her preferences and needs. The success of percutaneous endoscopic gastrostomy has led to increasingly frequent referrals for placement in critically ill elderly patients. Endoscopists therefore become a key figure in stimulating rational, correct treatment of these patients.
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