PEG Tube Placement

PEG (Percutaneous Endoscopic Gastrostomy) tube placement is a medical procedure used to insert a feeding tube directly into the stomach through the abdominal wall. This allows for direct access to the stomach, enabling patients to receive nutrition, fluids, and medications when they are unable to eat or swallow normally.

Indications

• Neurological disorders, such as stroke, cerebral palsy, or Parkinson's disease, that affect swallowing
• Cancer of the head, neck, or esophagus that obstructs the normal pathway for food and liquids
• Severe gastrointestinal disorders, like gastroparesis or intestinal obstruction
• Malnutrition or dehydration due to various medical conditions
• Need for long-term enteral nutrition support

Procedure

The PEG tube placement procedure typically involves the following steps:

1. Patient preparation: The patient is given local anesthesia and sedation to minimize discomfort during the procedure.
2. Endoscopy: A flexible tube with a camera (endoscope) is inserted through the mouth, passing through the esophagus and into the stomach.
3. Stomach insufflation: Air is introduced into the stomach to inflate it, allowing for better visualization.
4. PEG tube insertion: A needle is inserted through the abdominal wall and into the stomach under endoscopic guidance. A guidewire is then passed through the needle, and the PEG tube is threaded over the wire and into the stomach.
5. Tube securing: The PEG tube is secured to the abdominal wall using an internal bumper or a fixation device.

Types of PEG Tubes

There are several types of PEG tubes, including:

• Standard PEG tube: A basic feeding tube used for nutrition and medication administration.
• Balloon-retained PEG tube: A type of PEG tube that uses a balloon to secure the internal bumper.
• Locking PEG tube: A type of PEG tube with a locking mechanism to prevent accidental dislodgement.

Complications and Risks

Possible complications and risks associated with PEG tube placement include:

• Infection or abscess formation at the insertion site
• Bleeding or hematoma
• Perforation of the stomach or intestine
• Tube dislodgement or blockage
• Nutrient deficiencies or metabolic imbalances if not properly managed

Post-Procedure Care

After PEG tube placement, patients require:

• Regular cleaning and maintenance of the tube and surrounding skin
• Proper feeding and medication administration techniques
• Monitoring for signs of complications or tube malfunction
• Follow-up appointments with a healthcare provider to assess tube function and overall health

Removal of PEG Tube

A PEG tube can be removed when it is no longer needed, typically through a simple procedure:

1. Cutting the external portion of the tube
2. Deflating the internal bumper (if applicable)
3. Gently pulling out the tube

The stomach usually closes on its own, but in some cases, a small procedure may be required to close the opening.