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      Accidental late PEG dislodgment in 3 cases with a narrow stoma: Bougie dilatation rescue

      case-report

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          ABSTRACT

          Percutaneous endoscopic gastrostomy (PEG) is a simple and effective method of enteral nutrition for many patients who cannot take oral food. The accidental dislodgment of the PEG tube after the maturation of the gastrocutaneous fistula (stoma) is called late dislodgment. If it is not detected early, the stoma lumen gets narrower and does not permit the passage of the replacement tube. In this case, the commonly followed method is to continue enteral nutrition by opening a new gastrocutaneous fistula after the complete closure of the original stoma. Here, we present a stoma-saving bougie dilatation method in 3 cases with severely narrowed stomas after late accidental dislodgment of the PEG tube.

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          Gastrostomy without laparotomy: a percutaneous endoscopic technique.

          M W Gauderer, Jeffrey Ponsky, R J Izant (1980)
          A new technique has been developed to establish a tube feeding gastrostomy without a laparotomy. The procedure is particularly useful in high risk patients because general anesthesia is not usually required. The procedure is simple, safe, and rapid. It has been employed in 12 children (and 19 adults) with minimal morbidity and no mortality.
          Article 0 comments Cited 99 times – based on 0 reviews     Review now
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            Gastrostomy tube placement outcomes: comparison of surgical, endoscopic, and laparoscopic methods.

            Benjamin Fisher, R Rolandelli, Robin Bankhead (2005)
            Advances in percutaneous endoscopic gastrostomy (PEG) and laparoscopic (LAP) techniques now allow for less invasive placement of gastrostomy tubes. This study compared morbidities and feeding outcomes of these procedures with standard surgical (OPEN) insertion. Gastrostomy tubes placed in the operating room by the PEG, LAP, and OPEN methods were compared for insertion times, tube insertion and maintenance complications, enteral feeding complications, and feeding start days. Patients with concomitant intra-abdominal procedures were excluded. Patients were followed for 6 days after tube placement. A total of 91 catheters (PEG = 23, LAP = 39, OPEN = 29) were inserted in the operating room for indications of ventilator-dependent respiratory failure (45), dysphagia (30), head and neck cancer (9), and decreased mental status (7). No patients were fed on the day of the procedure. Insertion times were significantly longer (p < .05) in the OPEN technique (68 minutes) vs LAP (48 minutes) and PEG (30 minutes). Insertion complications occurred in the LAP and PEG cohorts (3 failed LAP, 1 failed PEG), and maintenance complications were higher in the LAP group, including 1 episode each of cellulitis, bleeding, and serous drainage. Twenty enteral feeding complications in 17 patients occurred in all groups (9 in LAP vs 6 in PEG and 5 in OPEN), and included emesis (6), high residual (5), diarrhea (3), ileus (3), nausea (2), and pain after feeding (1). Overall complications were significantly lower in the PEG (7) and OPEN (5) groups compared with the LAP group (15). Feeding start day was significantly delayed in the OPEN technique (2.1 days vs 1.7 in PEG and 1.5 in LAP); however, no difference was found in days to goal among groups (4.4-4.8 days). PEG should be the procedure of choice for placement of gastrostomy tubes. If PEG is contraindicated, then OPEN technique may be best due to fewer complications, although insertion time is longer than the LAP technique.
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              Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study

              Andrea Anderloni, Milena Di Leo, Franco Barzaghi … (2019)
              Article 0 comments Cited 19 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ulus Travma Acil Cerrahi Derg
                Journal ID (iso-abbrev): Ulus Travma Acil Cerrahi Derg
                Title: Turkish Journal of Trauma & Emergency Surgery
                Publisher: Kare Publishing (Turkey )
                ISSN (Print): 1306-696X
                ISSN (Electronic): 1307-7945
                Publication date Collection: December 2023
                Publication date (Electronic): 11 December 2023
                Volume: 29
                Issue: 12
                Pages: 1382-1384
                Affiliations
                [1 ]Başkent University Medicine Faculty, Istanbul Hospital, Department of Gastroenterology, İstanbul- Türkiye
                [2 ]Başkent University Medicine Faculty, Istanbul Hospital, Department of Anesthesiology, İstanbul- Türkiye
                [3 ]Bezmialem Vakif University Medicine Faculty, Department of Gastroenterology, İstanbul- Türkiye
                Author notes
                Address for correspondence: İbrahim Hakkı Köker, M.D. Department of Gastroenterology, Başkent University Medicine Faculty, Istanbul Hospital, İstanbul, Türkiye E-mail: koker34@ 123456yahoo.com
                Article
                Publisher ID: TJTES-29-1382
                DOI: 10.14744/tjtes.2023.09130
                PMC ID: 10767293
                PubMed ID: 38073451
                SO-VID: 19046be3-9583-4273-ac48-7daae04822c0
                Copyright © Copyright © 2023 Turkish Journal of Trauma and Emergency Surgery
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

                History
                Date received : 07 April 2023
                Date revision received : 30 August 2023
                Date accepted : 18 October 2023
                Categories
                Subject: Case Report

                Keywords: bougie dilatation,late peg dislodgment,peg stoma rescue
                Data availability:
                Keywords: bougie dilatation, late peg dislodgment, peg stoma rescue

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