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Percutaneous endoscopic gastrostomy tube

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
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
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...
October 5, 2018: Pediatric Surgery International
Adam L Jones
This case study presents a patient who has undergone right carotid endarterectomy complicated by glossopharyngeal nerve (or cranial nerve (CN) IX) injury. The patient had one transient ischaemic attack (TIA) three weeks before admission. A computed tomography (CT) scan two days after admission illustrated a right-sided parietal infarct. The patient subsequently had a CT angiogram, which showed a large, calcified plaque in the right internal carotid artery. He then underwent a right carotid endarterectomy...
July 25, 2018: Curēus
Mohamad Hasif Jaafar, Sanjiv Mahadeva, Kit Mun Tan, Ai-Vyrn Chin, Shahrul B Kamaruzzaman, Hui Min Khor, Nor Izzati Saedon, Maw Pin Tan
BACKGROUND: A barrier to gastrostomy feeding exists among Asian clinicians and caregivers due to negative perceptions regarding complications. We compared clinical and nutrition outcomes in older dysphagic Asian patients with nasogastric (NG) or gastrostomy tube feeding using a pragmatic study design. METHODS: The choice of enteral tube access was determined by managing clinicians and patients/caregivers. Comparisons of tube feeding methods were made during a 4-month period, adjusting statistically for inherent confounders...
September 25, 2018: Nutrition in Clinical Practice
Erik Folch, Fayez Kheir, Amit Mahajan, Daniel Alape, Omar Ibrahim, Eugene Shostak, Adnan Majid
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tube placement is a procedure frequently done in the intensive care unit. The use of a traditional endoscope can be difficult in cases of esophageal stenosis and theoretically confers an increased risk of infection due to its complex architecture. We describe a technique using the bronchoscope, which allows navigation through stenotic esophageal lesions and also minimizes the risk of endoscopy-associated infections. METHODS: Prospective series of patients who had PEG tube placement guided by a bronchoscope...
September 24, 2018: Journal of Intensive Care Medicine
Valentina Decimi, Barbara Parma, Roberto Panceri, Chiara Fossati, Milena Mariani, Silvia Russo, Cristina C Gervasini, Maurizio Cheli, Anna Cereda, Angelo Selicorni
Cornelia de Lange syndrome (CdLS) is a genetic condition characterized by intellectual disability, peculiar facial dysmorphisms, multiorgan malformations, and growth problems. Majority cases of CdLS are caused by mutations in genes of Cohesin pathway. Although feeding problems are a well-known feature, no specific data have been published about the use of nutritional devices. We analyzed use, type, time of introduction, and duration of nutritional devices in 73 CdLS patients. In total, 29/73 (40%) used a device; nasogastric tube (NGT) in 28/73 (38%) and percutaneous endoscopic gastrostomy (PEG) in 7/73 (10%)...
September 2018: American Journal of Medical Genetics. Part A
Dan Isaac Cohen-Addad, Kevin Hewitt, Donnie Bell
We report a case of a ventriculoperitoneal shunt incidentally found within the stomach while the patient was undergoing a percutaneous endoscopic gastrostomy (PEG) tube placement. Among the complications of ventriculoperitoneal shunt placement, bowel perforation is rare a complication found in 0.01%-0.07% of cases, and typically occurs in premature infants and neonates [1]. To date, less than 100 such cases have been recorded of which only a few have appeared in the radiological literature. Here we discuss the current literature, the radiological features, clinical presentations and the management...
December 2018: Radiology Case Reports
Anna Wiernicka, Małgorzata Matuszczyk, Agnieszka Szlagatys-Sidorkiewicz, Piotr Landowski, Ewa Toporowska-Kowalska, Beata Gębora-Kowalska, Katarzyna Popińska, Marta Sibilska, Urszula Grzybowska-Chlebowczyk, Sabina Więcek, Ewa Hapyn, Karolina Blimke-Kozieł, Jarosław Kierkuś
BACKGROUND & AIMS: We assessed the tolerability and safety of implementing early enteral nutrition in children at 3 h after percutaneous endoscopic gastrostomy (PEG) placement to establish an optimum feeding mode in paediatric patients that reduced the fasting period, the inadequate nutritional support interval, and the hospitalisation time. METHODS: Children with clinical indications for PEG placement were recruited from six medical centres in Poland to participate in the study...
August 28, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Kah Poh Loh, Maya Abdallah, Meng-Shiou Shieh, Mihaela S Stefan, Penelope S Pekow, Peter K Lindenauer, Supriya G Mohile, Dilip Babu, Tara Lagu
Background: Invasive mechanical ventilation (IMV), dialysis for acute kidney failure, and other critical care therapies (CCTs) are associated with a high risk for complications in patients with metastatic cancer. Inpatient palliative care (IPC) can assist in assessing patients' preferences for life-prolonging treatment at the end of life. This study investigated the use pattern of IPC, outcomes (in-hospital mortality, length of stay [LOS], discharge destination, and cost of care), and predictors of IPC use in patients with metastatic cancer who received CCTs...
September 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Michio Maruyama, Shohei Iijima, Nobuya Ishibashi, Michio Inukai, Tetsuharu Oriishi, Naruo Kawasaki, Naomi Kurata, Yutaka Suzuki, Isao Tabei, Masahiro Chiba, Etsuko Nakamura, Takashi Higashiguchi
BACKGROUND/AIMS: The current study was undertaken to assess if the semi-solid formulas could be used with a new ENFit connector with similar force to current percutaneous endoscopic gastrostomy (PEG) tubes. METHODS: Experiment 1: We measured the applied pressure (force) needed to compress the syringe containing 7 viscous semi-solid formulas with a 20 Fr PEG tube and low-profile tube through the ENFit connector or the current connector. Experiment 2: This experiment was conducted to evaluate the compression force through 2 connectors in 3 infusion velocity, 7 PEG tube types with 2 semi-solid formulas...
2018: Annals of Nutrition & Metabolism
Julie Gallagher
RATIONALE: Pathophysiologic mechanisms of the central nervous system, such as stroke, can be associated with intractable hiccups. Intractable hiccups can be associated with potentially fatal consequences, thus requiring safe management in an inpatient rehabilitation facility (IRF) setting with a multidisciplinary team approach to optimize mobility and feeding. PATIENT CONCERNS: A 49-year-old male presented to the emergency department with complaints of vomiting and dizziness...
August 2018: Medicine (Baltimore)
Soo-Kyung Park, Ji Yeon Kim, Seong-Joon Koh, Yoo Jin Lee, Hyun Joo Jang, Soo Jung Park
BACKGROUND: Gastrostomy tube insertion is beneficial to selected patients, and percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are two of the frequently used methods in gastrostomy. This study aimed to investigate the indications and complications of both PEG and PRG. METHODS: This was a retrospective multicenter cohort study. Patients who underwent initial PEG or PRG tube insertion for nutritional purpose between January 2010 and December 2015 at five university hospitals were included in the study...
August 21, 2018: Surgical Endoscopy
Helsa Teh, Lisa Winters, Fleur James, Peter Irwin, Catherine Beck, Caroline Mansfield
OBJECTIVE: To describe 5 cases of conservative management of substantial esophageal perforation in dogs. SERIES SUMMARY: Five dogs presented with an esophageal foreign body (EFB) and resultant esophageal perforation. Clinical signs at presentation included tachycardia, tachypnea, and increased respiratory effort. Thoracic radiography was performed in all cases, and in each case, pleural and mediastinal effusion was present, suggesting esophageal perforation prior to endoscope-guided removal...
September 2018: Journal of Veterinary Emergency and Critical Care
Paolo Orlandoni, Nikolina Jukic Peladic, Mirko Di Rosa, Claudia Venturini, Donata Fagnani, Debora Sparvoli, Natascia Giorgini, Redenta Basile, Claudia Cola
BACKGROUND AND AIMS: European and international guidelines advice against initiating tube-feeding in patients with severe dementia. These recommendations are based on studies with important methodological limitations that evaluated the benefits of artificial nutrition in patients with percutaneous endoscopic gastrostomy almost exclusively in terms of the prolongation of survival. The aims of this study were to assess the harmful effects of home enteral nutrition administered via the nasogastric tube and percutaneous endoscopic gastrostomy in patients with advanced dementia in terms of mechanical, gastrointestinal and metabolic complications, to estimate the survival, to explore the risk factors for mortality and to compare the outcomes of patients with advanced dementia with those of patients without dementia...
July 20, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Balasubramanian Karthikumar, Shyamkumar N Keshava, Vinu Moses, George K Chiramel, Munawwar Ahmed, Suraj Mammen
Background: Interventional radiology (IR) has played an important role in the technical evolution of gastrostomy, from the first surgical, endoscopical to percutaneous interventional procedures. Aim: This study is done to assess the technical feasibility and outcome of IR-guided percutaneous gastrostomy for patients requiring nutritional support for neuromuscular disorders or head and neck malignancies, as well as to describe simplified and newer technique for pull-type gastrostomy...
April 2018: Indian Journal of Radiology & Imaging
Keith Siau, Tom Troth, Elizabeth Gibson, Anita Dhanda, Lauren Robinson, Neil C Fisher
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes allow for long-term enteral feeding. Disk-retained PEG tubes may be suitable for long-term usage without planned replacement, but data on longevity are limited. We aimed to assess the rates and predictors of PEG longevity and post-PEG mortality. DESIGN: Single-centred retrospective cohort study of patients with disk-retained (Freka) PEG tubes. METHODS: All patients undergoing PEG between 2010 and 2013 were identified, and retrospective analysis of outcomes until 2017 (median 1062 days) was performed...
August 2018: Postgraduate Medical Journal
Chih-Cheng Tsao, Shih-Yu Lee, Wei-Kuo Chang, Kuen-Tze Lin, Sheng-Der Hsu, Chen-Liang Tsai, Chun-Shu Lin
OBJECTIVES: To investigate whether percutaneous endoscopic gastrostomy (PEG) tube placement is associated with increased risk of gastric cancer. METHODS: We conducted a nationwide population-based retrospective study in Taiwan. Inpatient data from 1997 to 2010 were collected from Taiwan National Health Insurance Research Database. Patients with age less than 20 years; those with histories of PEG before 2000; those with histories of cancers; and those diagnosed with gastric cancer before or within 6 months of the first PEG procedure were excluded...
September 2018: Medical Hypotheses
Eduardo Aimore Bonin, Paulo Roberto Walter Ferreira, Marcelo de Paula Loureiro, Thais Andrade Costa-Casagrande, Paolo de Oliveira Salvalaggio, Guilherme Francisco Gomes, Rafael William Noda, Christopher John Gostout, Leandro Totti Cavazzola
BACKGROUND: In order to simplify a percutaneous gastrostomy procedure and avoid the need of endoscopy or imaging methods, a novel percutaneous magnetically guided gastrostomy (PMG) technique was conceived. The aim of the present study is to evaluate the feasibility of a novel PMG technique with no endoscopy or any imaging guidance in a porcine model. METHODS: Fourteen crossbred domestic pigs were used for prototype development (cadaveric experiments) and proof-of concept, survival study...
November 2018: Surgical Endoscopy
Young Lee, Gregory Zielinski, Jasmine Bhinder, Sandeep Sirsi, Armand Asarian
Gastrostomy tubes can be used to provide long-term nutrition and feeding when oral intake is not adequate. A rare but serious complication includes iatrogenic small bowel injury. The incidence of this is infrequent due to its position of the small bowel beneath the omentum, however, injury leading to obstruction and volvulus has been previously described in the literature. We present an unusual case of gastrostomy tube transection into omental fat causing a kink in the small bowel allowing for a transition point of obstruction and subsequent erosion of the gastrostomy tube into the small bowel...
July 2018: Journal of Surgical Case Reports
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