Percutaneous Endoscopic Gastrostomy

A percutaneous endoscopic gastrostomy (PEG) procedure may be required when oral food and fluid intake is impossible due to oesophageal obstruction or hazardous because swallowing mechanisms are impaired increasing the risk of aspiration. The gastrostomy tube is placed at gastroscopy, under conscious sedation and local anaesthesia.

Notes:

Informed consent is required. This requires consultation with Gastroenterology and often, review by the PEG Nurse Specialist. Ethical, procedural and overall medical issues need to be considered.
A PEG does not eliminate the risk of aspiration.

Complications
- Skin Infection - ensure that the tube is not too tight and can rotate freely in the subcutaneous tract. Antibiotics are likely to be required.
- Peritonitis - If leakage or early tube dislodgement, start antibiotics and seek advice from Gastroenterology (PEG Nurse 80965, Gastroenterology Registrar or Consultant).
- Inadvertent Tube Removal
  - Early - risk of peritonitis.
  - >2 weeks. By this time the tract has epithelialized. Place a Foley urinary catheter to maintain the tract which starts to close within 1-2 hours. Seek advice as above.


Information about this CDHB document (1442):
Document Owner:	Blue Book Editorial Committee (see Who's Who)
Issue Date:	December 2013
Next Review:	December 2015
Keywords:
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.
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Topic Code: 1442