First Year Fellows Endoscopy Course (July 28-29)

9-Feeding tubes

Pdf Summary

This document provides an overview of percutaneous gastrostomy tubes (PEG) and their placement. PEG tubes are used when patients are unable to tolerate adequate oral intake due to various reasons such as nutrition, hydration, medications, and gastric decompression. Before the procedure, a pre-PEG assessment is conducted which includes evaluating the patient's medications, GI anatomy, nutritional status, co-morbidities, and obtaining informed consent. The document also discusses the management of antithrombotic agents before and after the procedure, as well as contraindications and relative contraindications to PEG placement.<br /><br />The technique for PEG placement involves using a percutaneous kit with key components such as a scalpel, angiocatheter, PEG tube, Y-port adapter, and wire. The safe tract technique is employed to minimize complications, and the procedure is guided by endoscopic visualization. After the tube is placed, the bumper is secured and repeat endoscopy is not necessary if no problems are suspected during the procedure.<br /><br />The document also highlights potential adverse events associated with PEG placement, such as aspiration, infection, bleeding, pneumoperitoneum, and post-procedure complications. It provides information on the prevention and management of these complications. Other topics discussed include PEG tube migration, replacement tubes, and PEG removal. The document concludes with a set of questions to consider when assessing a patient with a PEG tube.

Keywords

percutaneous gastrostomy tubes

PEG tubes

oral intake

nutrition

hydration

medications

gastric decompression

pre-PEG assessment

antithrombotic agents

PEG placement