Percutaneous endoscopic gastrostomy
A percutaneous endoscopic gastrostomy (PEG) is a feeding tube placed through the wall of the abdomen directly into the stomach. It is a minor surgical procedure and is inserted using gastroscopy. This allows the mouth and oesophagus to be bypassed and assists with feeding in individuals where swallowing is a problem.
Indications for the insertion of a PEG include conditions which affect or prevent normal swallowing, amongst others:
- Neurological disorders preventing normal oropharyngeal swallowing
- Degenerative neurological disorders
- Prolonged ICU admission
- Surgery to the head and neck
The procedure has significant risks and so there should be good reason to perform it. Preferably a speech therapist and dietician should be involved in the management of and decision-making regarding placement of a PEG. The PEG should be managed in conjunction with a specialist familiar with their use.
- Sedation-related complications during the placement of the PEG, including respiratory suppression and aspiration.
- Hypostatic or aspiration pneumonia - Chest physiotherapy post-procedure is important to prevent these.
- Infection at the PEG site.
- Bleeding from the PEG site.
- Displacement of the PEG intra-peritoneally - Feeds may leak into the abdominal cavity in this situation, and it may be life-threatening.
- Necrosis of the abdominal wall or stomach wall due to excessive traction on the PEG.