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percutan endoscopic gastrostomy

Saad Saleem, Wissam Bleibel
A 33-year-old man was admitted to the hospital with upper abdominal pain and melena. Laboratory tests were suggestive of pancreatitis. Computed tomography (CT) of the abdomen showed peripancreatic fat stranding but showed no free air in the peritoneal cavity. Esophagogastroduodenoscopy (EGD) was performed, which revealed an ulcer on the posterior wall of the stomach, caused by the inner tip of the gastrostomy tube, and which had penetrated the pancreas. He had no signs of peritonitis. The gastrostomy tube was exchanged...
July 5, 2018: Curēus
Ayman Goneidy, Georgina Malakounides, Adil Aslam
AIM: Buried Bumper (BB) is a complication of percutaneous endoscopic gastrostomy (PEG) that leads to tube dysfunction and major morbidity. Although many techniques have been described to manage BB, none are universally adopted, and laparotomy remains the mainstay. We introduce a novel endoscopic technique in paediatric surgery that avoids laparotomy. METHODS: A retrospective review of medical records of patients who presented with BB to Cambridge University Hospital, UK, between January 2012 and June 2018 was done...
November 7, 2018: Journal of Pediatric Surgery
Diana Martins, Sara Pires, Pedro Pimentel-Nunes, Rui Almeida Silva, Claúdia Camila Dias, Mário Dinis-Ribeiro
Background/Aims: Dysphagia due to benign pharyngoesophageal strictures (PES) often requires repeated dilations; however, a uniform definition for the therapeutic efficacy of this technique has not been yet established. We aimed to assess the overall efficacy of endoscopic dilation of pharyngoesophageal anastomotic or post-radiotherapy (post-RT) strictures. Methods: The data of 48 patients with post-RT ( n = 29) or anastomotic PES ( n = 19) submitted to endoscopic dilation during a 3-year period were retrospectively assessed...
November 2018: GE Portuguese Journal of Gastroenterology
Jacob J Bundy, William J Weadock, Jeffrey Forris Beecham Chick, Rajiv N Srinivasa, Nishant Patel, Evan Johnson, Mamdouh Khayat, Brian Jeffers, Joseph J Gemmete, Ravi N Srinivasa
PURPOSE: To create a three-dimensional endoscopic model of the biliary tract from magnetic-resonance cholangiopancreatography imaging and to evaluate its effectiveness as a tool for training in endoscopic biliary interventions. MATERIALS AND METHODS: A magnetic-resonance cholangiopancreatography study was performed on a patient with biliary obstruction secondary to a distal bile duct cholangiocarcinoma. Using Vitrea, a three-dimensional volume-rendered image was created, and exported as a standard tessellated language file...
August 29, 2018: Current Problems in Diagnostic Radiology
Narong Kulvatunyou, Steven A Zimmerman, Moutamn Sadoun, Bellal A Joseph, Randall S Friese, Lynn M Gries, Terence O'Keeffe, Andrew L Tang
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) complications are often under-reported in the literature, especially regarding the incidence of tube dislodgement (TD). TD can cause significant morbidity depending on its timing. We compared outcomes between "push" and "pull" PEGs. We hypothesized that push PEGs, because of its T-fasteners and balloon tip, would have a lower incidence of TD and complications compared with pull PEGs. METHODS: We performed a chart review of our prospectively maintained acute care surgery database for patients who underwent PEG tube placement from July 1, 2009 through June 30, 2013...
December 2018: Journal of Surgical Research
Chris Lennard
This article describes the role of nurses assisting people with degenerative illness in advance care planning (ACP) for a time when they may lose decision-making capacity. It looks at the concept of advance decisions to refuse treatment (ADRT), as defined in the Mental Capacity Act 2005 , exploring the legal, ethical and philosophical ramifications of carrying out, or overriding, formerly expressed wishes of someone who has subsequently lost decision-making capacity. It uses an illustrative composite case study of an individual with Huntington's disease whose prognosis includes future deterioration in swallowing, together with consideration of whether to have or refuse a percutaneous endoscopic gastrostomy...
November 22, 2018: British Journal of Nursing: BJN
Gülhan Saricam, Dogan Akdogan, Kadriye Kahveci
Stroke is the leading cause of disability and one of the most common reasons of death around the world. Information is not sufficient on the palliative care (PC) needs of stroke patients and factors affecting their prognosis. In this study, we have investigated the demographics and comorbidities of stroke patients followed-up in a PC center (PCC), and the factors efficient on their prognosis. Medical records of 132 patients followed-up in PCC with stroke diagnosis between years 2016 and 2017 were reviewed retrospectively...
November 19, 2018: Acta Neurologica Belgica
Brigitta Balogh, Tamás Kovács, Amulya Kumar Saxena
INTRODUCTION: The aim of this study was to analyze the complication rates and mortality in association with different operative techniques of percutaneous endoscopic gastrostomy (PEG), age, underlying diseases and other risk factors. Moreover, analysis of the indications of PEG insertion and the underlying comorbidities was also performed. METHODS: This study performs a literature analysis of PEG-related complications in children. Literature was searched on PubMed® (1994-2017) using terms "percutaneous endoscopic gastrostomy", "complications", "mortality" and "children"...
November 19, 2018: World Journal of Pediatrics: WJP
Carmen Molina Villalba, Juan Antonio Vázquez Rodríguez, Francisco Gallardo Sánchez
Percutaneous endoscopic gastrostomy (PEG) is an effective and safe method for nutritional support in patients with malnutrition and impossibility of oral intake with an estimated survival higher than the months that require enteral nutrition beyond four weeks. The main indications include neoplasms of the upper air-digestive tract and neurological diseases, with dementia currently considered a controversial indication. Anatomical alterations and infectious diseases are the most frequent contraindications. There are different endoscopic techniques; the most widely used being the "pull" method, with a low mortality...
November 10, 2018: Medicina Clínica
Kara A Rothenberg, Barnard J Palmer, Olajire Idowu, Sunghoon Kim
BACKGROUND: There are various methods to place a gastrostomy tube. We report a laparoscopic method to place a standard percutaneous endoscopic gastrostomy (PEG) tube without the use of endoscopy. METHODS: Laparoscopic magnet-assisted PEG placement was carried out using an orogastric tube attached with a magnet that is used to retrieve the PEG wire that has been percutaneously placed into the stomach. RESULTS: Four pediatric patients (mean age 31 months) underwent a PEG tube placement using the laparoscopic magnet-assisted PEG tube insertion technique during 2017...
November 8, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Hee Kyong Na, Ji Yong Ahn, Gin Hyug Lee, Jeong Hoon Lee, Do Hoon Kim, Kee Wook Jung, Kee Don Choi, Ho June Song, Hwoon-Yong Jung
BACKGROUND AND AIM: We developed a novel training simulator for percutaneous endoscopic gastrostomy (PEG) and determined its efficacy and realism in PEG insertion training. METHODS: The gastrostomy simulator was made using three-dimensional printing and silicone molding technology. The simulator is of two types: pull type and introducer type. We enrolled 20 participants, comprising 10 beginners with no experience of PEG insertion and 10 PEG-experienced endoscopists...
October 29, 2018: Journal of Gastroenterology and Hepatology
Nirupama Yechoor, Amir Adeli, Shaheryar Hafeez
INTRODUCTION: Although overall mortality of status epilepticus is high, baseline patient characteristics and co-morbidities may be helpful to predict outcomes and shape treatment decisions. Two previously published scoring systems exist to predict outcomes: the Status Epilepticus Severity Score (STESS) and the Epidemiology-based Mortality Score in Status Epilepticus (EMSE). However, a comparison of the two scores has not previously been completed in an American intensive care unit. We hypothesize that both scores will adequately predict the primary outcome of in-hospital death, but that the EMSE may more accurately predict functional outcomes, and significantly impact treatment decisions for both clinicians and families...
October 3, 2018: Epilepsy Research
Luigi Sivero, Donato Alessandro Telesca, Maurizio Gentile, Giovanni Aprea, Guido Massa, Giovanni Cestaro, Michele Danzi, Stefania Sivero, Cesare Formisano
BACKGROUND AND AIMS: Ethical and medico-legal issues reviews of Percutaneous Endoscopic Gastrostomy (PEG) placement in elderly patients is an important topic of international medical literature. PEG is often inappropriately placed in patients with not spontaneous oral feeding intake, cause of unrealistic expectations. We performed a critical review of the literature for placement of PEG in geriatric patients. METHODS: A literature review was performed about the positioning of the PEG in geriatric patients with dementia and severe anorexia...
2018: Annali Italiani di Chirurgia
Cristians Gonzalez, Jung-Myun Kwak, Federico Davrieux, Ryohei Watanabe, Jacques Marescaux, Lee Swanstrom
BACKGROUND: Gastroparesis is a rapidly increasing problem with sometimes devastating consequences. While surgical treatments, particularly laparoscopic pyloroplasty, have recently gained popularity, they require general anesthesia, advanced skills, and can lead to leaks. Peroral pyloromyotomy is a less invasive alternative; however, this technique is technically demanding and not widely available. We describe a hybrid laparo-endoscopic collaborative approach using a novel gastric access device to allow endoluminal stapled pyloroplasty as an alternative treatment option for gastric outlet obstruction...
October 17, 2018: Surgical Endoscopy
Bebiana Conde, Natália Martins, Inês Rodrigues, Ana Claúdia Pimenta, João Carlos Winck
(1) Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative condition, whose bulbar involvement compromises language, swallowing, and airway protection. When oral nutrition is no longer adequate, percutaneous endoscopic gastroscopy (PEG) may be indicated. However, as exact timing is still debatable, we tried to find it. (2) Methods: A prospective cohort study was performed using fiber-optic endoscopic evaluation of swallowing (FEES), functional evaluation scales (ALS Functional Rating Scale-Revised (ALSFRS-R) and bulbar sub-score (ALSFRS-R-B)), lung function tests (like Forced Vital Capacity (FVC), Cough Peak Flow (CPF)) and anthropometric data...
October 14, 2018: Journal of Clinical Medicine
Vered Hermush, Yitshal Berner, Yael Katz, Yanina Kunin, Irena Krasniansky, Yael Schwartz, Debbie Mimran Nahon, Ana Elizariev, Gad Mendelson
Background: The use of gastrostomy tubes for long-term nutritional support in older patients is frequent. Percutaneous gastrostomy tube placement may be performed using various techniques, including endoscopic, surgical, and radiologically-guided methods. While percutaneous endoscopic gastrostomy (PEG) placement is the most widely used and accepted approach, experience with the use of percutaneous radiological gastrostomy (PRG) is more limited. Objective: To evaluate the safety and short-term outcomes of PRG in older patients requiring long-term enteral feeding...
2018: Frontiers in Medicine
Takuji Fujinaga, Masaki Ikeda, Koji Takahashi, Teruya Komatsu, Toshitaka Suzuki, Kunihiko Yasuda
Omentoplasty has been accepted as an effective surgical procedure for fistulated empyema. However, it is difficult for patients with poor nutritional status because their omental volume is often too poor to be applied for omentoplasty. Percutaneous endoscopic gastrostomy(PEG) is useful for long-term nutritional management. There is no report on safety and usefulness of PEG before omentoplasty. We report a case of omentoplasty that was successfully performed after nutritional enforcement by using percutaneous endoscopic gastrostomy in a patient of postoperative empyema with fistula...
October 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Nicholas E Bruns, Ian C Glenn, Domenic R Craner, Steve J Schomisch, Michael R Harrison, Todd A Ponsky
BACKGROUND: Magnetic compression anastomosis (magnamosis) is the process of forming a sutureless anastomosis of the gastrointestinal tract using two magnetic Harrison rings. It has been shown to be effective in stomach, small bowel and colon, but has not been implemented in the esophagus. A pure esophageal atresia porcine model was developed to test the concept. METHODS: Five pigs weighing between 35 and 65 kg were used. In all pigs, a percutaneous endoscopic gastrostomy (PEG) tube was placed, and a right thoracotomy was performed...
September 29, 2018: Journal of Pediatric Surgery
C Gonzalez, J-M Kwak, F Davrieux, R Watanabe, J Marescaux, L L Swanström
Flexible endoscopy has evolved to the point that it includes many endoluminal procedures that once required open or laparoscopic surgery, for instance, antireflux surgery, pyloromyotomy, mucosal and submucosal tumor resections, and even full-thickness resection. However, these procedures remain technically demanding due to flexible technology issues: difficult imaging, limited energy devices, lack of staplers, unsatisfactory suturing abilities, and so on. Transgastric laparoscopy or hybrid laparoscopy/flex endoscopy has been described for almost two decades as an alternative to a pure endoluminal approach, mainly for pancreatic pseudocyst drainage and full-thickness and mucosal resection of various lesions...
October 8, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Filip Sandberg, Margrét Brands Viktorsdóttir, Martin Salö, Pernilla Stenström, Einar Arnbjörnsson
PURPOSE: A meta-analysis was performed to compare the rates of the major complications associated with two gastrostomy tube placement techniques in a pediatric population: laparoscopy-assisted gastrostomy (LAG) and percutaneous endoscopic gastrostomy (PEG). METHODS: The PubMed electronic database was queried for comparative studies of the two insertion techniques. The Newcastle-Ottawa scale (NOS) was used for the assessment of the quality and risk of bias in the included studies...
December 2018: Pediatric Surgery International
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