Percutaneous Endoscopic Gastrostomy

Indications

• • Establishment of enteral access for feeding

  • Gut decompression

  • Patients who are unable to move food from their mouth to their stomach

    • neurologic disorders (stroke, cerebral palsy, brain injury, amyotrophic lateral sclerosis, impaired swallowing)

    • trauma, cancer, UGI or the respiratory tract surgery;

  • Gut decompression

    • abdominal malignancies causing gastric outlet or small-bowel obstruction or ileus.

Contraindications

• • Absolute

    • Uncorrected coagulopathy or thrombocytopenia

    • Severe ascites

    • Hemodynamic instability

    • Sepsis

    • Intra-abdominal perforation

    • Active peritonitis

    • Abdominal-wall infection at the selected site of placement

    • Gastric outlet obstruction (if the PEG tube is being placed for feeding)

    • Severe gastroparesis (if the PEG tube is being placed for feeding)

    • History of total gastrectomy

    • Lack of informed consent for the procedure

  • Relative

    • Presence of oropharyngeal or esophageal malignancy (potential risk of seeding of the PEG tract)

    • Hepatomegaly

    • Esophageal malignancy that will require the use of the stomach as a conduit for reconstruction following definitive esophageal resection

    • Splenomegaly

    • Portal hypertension with gastric varices

    • History of prior abdominal surgical procedures (possible presence of adhesions and bowel interposition)

    • Ventral hernia

    • Peritoneal dialysis

    • History of partial gastrectomy