First Year Fellows Endoscopy Course (July 28-29)

10-Feeding tubes_2024

Pdf Summary

The document discusses the placement and management of percutaneous gastrostomy tubes (PEG) in patients with various indications such as inability to tolerate oral intake, nutrition, hydration, and malignancies. It highlights the importance of pre-PEG assessments, including evaluating medications, antibiotics, and antithrombotic agents. Management of antithrombotic agents is based on patient risk classification, with guidelines for holding and restarting medications. Contraindications to PEG placement are outlined, along with relative contraindications. The PEG tray contents and the technique for PEG placement are described in detail.<br /><br />The text mentions potential adverse events during and after the PEG procedure, including aspiration, infection, bleeding, pneumoperitoneum, leaking, gastrocolic fistula, buried bumper syndrome, and tube-related complications. Specific guidance is provided on managing complications like aspiration, infection, and pneumoperitoneum.<br /><br />Additionally, it covers topics like tube migration, tube replacement, PEG removal, and tube migration, as well as addressing common issues like PEG tube pull-out and site metastases. Practical advice is given for dealing with scenarios like early or late PEG tube dislodgement or replacement. The document provides guidance on assessment and management strategies for PEG-related complications, emphasizing the importance of thorough evaluations, monitoring, and appropriate interventions in addressing potential issues.

Keywords

Percutaneous gastrostomy tubes

PEG placement

Nutrition

Hydration

Malignancies

Pre-PEG assessments

Antithrombotic agents

Complications

Tube migration

PEG-related complications