First Year Fellows Endoscopy Course ( August 6-7)

9-Feeding tubes

Pdf Summary

This document provides a summary of the content discussed in a course on percutaneous gastrostomy tubes (PEG). PEG placement is indicated for patients who are unable to tolerate oral intake for an extended period of time, such as in cases of nutrition, hydration, and medication administration. Prior to the procedure, various assessments need to be conducted, including evaluating the patient's medications, GI anatomy, nutritional status, and co-morbidities. Antibiotic prophylaxis is also recommended during the procedure. The management of antithrombotic agents for patients undergoing PEG placement is based on the patient's risk level, with low-risk patients holding the antithrombotics and high-risk patients holding them and bridging with LMWH. Contraindications and relative contraindications to PEG placement are discussed, along with the contents of a PEG tray and the technique for PEG placement. Adverse events related to PEG placement, such as aspiration, infection, bleeding, and pneumoperitoneum, are addressed, as well as post-procedure complications like leakage, gastrocolic fistula, and buried bumper syndrome. The management of complications and issues related to PEG removal and replacement are also discussed. The document concludes by providing a list of questions that can be used to assess a patient with a PEG.

Keywords

percutaneous gastrostomy tubes

PEG placement

oral intake

nutrition

hydration

medication administration

assessments

antibiotic prophylaxis

adverse events

complications management