637 results match your criteria Percutaneous Endoscopic Gastrostomy PEG Tube Placement


Nasopharyngeal Swab for COVID-19 Test Necessitating Mechanical Ventilation and Tracheostomy.

Cureus 2021 Mar 15;13(3):e13908. Epub 2021 Mar 15.

Internal Medicine, University of Pittsburgh Medical Center Pinnacle, Harrisburg, USA.

We present the first-ever reported case of massive epistaxis following nasopharyngeal (NP) swabbing requiring intubation and tracheostomy. A 67-year-old male with a mechanical aortic valve on warfarin presented from a nursing home to the emergency department with hypoxia. NP swab for coronavirus disease 2019 (COVID-19) was obtained, immediately followed by significant epistaxis. Read More

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Voltage-Gated Calcium Channel Antibody-Induced Oropharyngeal Dysphagia Presenting as a Paraneoplastic Neurological Complication in Breast Cancer.

Cureus 2021 Mar 3;13(3):e13677. Epub 2021 Mar 3.

Hematology/Oncology, Magee Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, USA.

Paraneoplastic neurologic syndromes (PNS) are a group of disorders characterized by an autoimmune response against the nervous system due to cross-reactivity between malignant and normal neural tissue. The most commonly associated malignancies include small cell lung cancer, ovarian cancer, breast cancer, and lymphoma. Multiple PNS have been reported including paraneoplastic cerebellar degeneration, retinopathy, sensorimotor peripheral neuropathy, encephalopathy, opsoclonus-myoclonus syndrome, and stiff-person syndrome. Read More

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Early versus late tube feeding initiation after PEG tube placement: Does time to feeding matter?

Injury 2021 May 4;52(5):1198-1203. Epub 2021 Mar 4.

Morehouse School of Medicine, Department of Surgery, 720 Westview Drive SW, Atlanta, GA 30310, USA. Electronic address:

Background: Variation exists in the timing of tube feed initiation after percutaneous endoscopic gastrostomy (PEG) tube placement. The aim of our study was to review outcomes of early tube feed (ETF) versus late tube feed (LTF) initiation after PEG tube placement.

Methods: We performed a retrospective review of all trauma patients who underwent PEG tube placement from 1/2014 to 12/2018. Read More

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Seeding of Gastrostomy Tube Site in Patient with Squamous Cell Carcinoma of the Tongue: A Case Report.

Nutr Clin Pract 2020 Dec 8. Epub 2020 Dec 8.

Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.

Enteral nutrition (EN) is a widely used therapeutic tool to provide nutrition support for patients with various clinical conditions, including different types of cancer. Head and neck cancers, often complicated by dysphagia, are among leading indications for enteral feeding. Percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic jejunostomy (PEJ) tubes are typically used to deliver EN. Read More

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December 2020

May chronic cough in chronic obstructive pulmonary disease be a contraindication of Percutaneous Endoscopic Gastrostomy placement: a case report.

BMC Gastroenterol 2021 Jan 21;21(1):31. Epub 2021 Jan 21.

Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.

Background: Percutaneous Endoscopic Gastrostomy (PEG) can involve some complications, despite the good safety of its track record. The Buried Bumper Syndrome (BBS) is a rare, late and dangerous complication that consists in the erosion of the internal bumper through the gastric wall. Case presentation We report the development of BBS in a man with chronic obstructive pulmonary disease (COPD) who had a persistent chronic cough which was prevalently but not solely in the morning and required placement of a PEG tube for continuous infusion of Levodopa/carbidopa intestinal gel for advanced Parkinson's disease. Read More

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January 2021

Rectal Bleeding after Insertion of a Percutaneous Endoscopic Gastrostomy Tube.

Case Rep Gastroenterol 2020 Sep-Dec;14(3):637-643. Epub 2020 Nov 30.

Digestive Diseases, Liver Center and Advanced Endoscopy Center, King Abdullah Medical City, Makkah, Saudi Arabia.

Iatrogenic injury to an internal organ such as the stomach, colon, small bowel, or liver after percutaneous endoscopic gastrostomy (PEG) tube insertion is a rare complication. We present a case of rectal bleeding due to colon injury during PEG tube placement. This required urgent exploratory laparoscopic surgery with segmental resection of the transverse colon and replacement of the PEG tube. Read More

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November 2020

Endoscopic rescue of early percutaneous endoscopy gastrostomy tube dislodgement.

Surg Endosc 2021 Apr 4;35(4):1915-1920. Epub 2021 Jan 4.

Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA.

Background: Percutaneous endoscopic gastrostomy (PEG) tube placement is one of the most common methods for establishing durable enteral access. Early PEG dislodgement occurs in < 5% of cases but typically prompts urgent surgical intervention to reestablish the gastrocutaneous tract and prevent intra-abdominal sepsis. To date, there is a single case report in the literature where successful endoscopic "rescue" of an early dislodged PEG tube negated the need for operative intervention. Read More

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Continuous Negative Pressure Operative Field Barrier for Combined Open Tracheostomy and Percutaneous Endoscopic Gastrostomy Tube Placement During Coronavirus Disease 2019.

A A Pract 2020 Dec 21;14(14):e01371. Epub 2020 Dec 21.

From the Department of Anesthesiology and Perioperative Medicine.

Respiratory failure in coronavirus disease 2019 (COVID-19) patients with prolonged endotracheal intubation may require a tracheostomy and percutaneous endoscopic gastrostomy (PEG) tube placement to facilitate recovery. Both techniques are considered high-risk aerosol-generating procedures and present a heightened risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for operating room personnel. We designed, simulated, and implemented a portable, continuous negative pressure, operative field barrier system using standard equipment available in hospitals to enhance health care provider safety during high-risk aerosol-generating procedures. Read More

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December 2020

Endoscopic management of enteral tubes in adult patients - Part 2: Peri- and post-procedural management. European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

Endoscopy 2021 Feb 21;53(2):178-195. Epub 2020 Dec 21.

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.

ESGE recommends the "pull" technique as the standard method for percutaneous endoscopic gastrostomy (PEG) placement.Strong recommendation, low quality evidence.ESGE recommends the direct percutaneous introducer ("push") technique for PEG placement in cases where the "pull" method is contraindicated, for example in severe esophageal stenosis or in patients with head and neck cancer (HNC) or esophageal cancer. Read More

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February 2021

Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy.

Radiat Oncol 2020 Dec 14;15(1):281. Epub 2020 Dec 14.

Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Background: Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH).

Methods: TRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n = 310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG). Read More

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December 2020

Endoscopic management of enteral tubes in adult patients - Part 1: Definitions and indications. European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

Endoscopy 2021 Jan 1;53(1):81-92. Epub 2020 Dec 1.

Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands.

ESGE recommends considering the following indications for enteral tube insertion: (i) clinical conditions that make oral intake impossible (neurological conditions, obstructive causes); (ii) acute and/or chronic diseases that result in a catabolic state where oral intake becomes insufficient; and (iii) chronic small-bowel obstruction requiring a decompression gastrostomy.Strong recommendation, low quality evidence.ESGE recommends the use of temporary feeding tubes placed through a natural orifice (either nostril) in patients expected to require enteral nutrition (EN) for less than 4 weeks. Read More

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January 2021

Multicenter cohort study of patients with buried bumper syndrome treated endoscopically with a novel, dedicated device.

Gastrointest Endosc 2020 Nov 19. Epub 2020 Nov 19.

Royal Free Unit for Endoscopy, The Royal Free Hospital and University College London Institute for Liver and Digestive Health, Hampstead, London, UK.

Background And Aims: Buried bumper syndrome (BBS) is a rare adverse event of percutaneous endoscopic gastrostomy (PEG) placement in which the internal bumper migrates through the stomal tract to become embedded within the gastric wall. Excessive tension between the internal and external bumpers, causing ischemic necrosis of the gastric wall, is believed to be the main etiologic factor. Several techniques for endoscopic management of BBS have been described using off-label devices. Read More

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November 2020

An Early Presentation of Buried Bumper Syndrome.

Cureus 2020 Oct 15;12(10):e10969. Epub 2020 Oct 15.

Internal Medicine, Ascension St. John Hospital and Medical Center, Detroit, USA.

Percutaneous endoscopic gastrostomy (PEG) is a well-established and successful method of nutritional delivery. Complications, although rare, are divided into early or late. Buried bumper syndrome (BBS) is usually a late complication of PEG tube insertion and can cause many issues such as pressure necrosis, peritonitis, and septic shock. Read More

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October 2020

Trends and outcomes of percutaneous endoscopic gastrostomy in hospitalized patients with malignant and nonmalignant ascites: a nationwide population study.

Ann Gastroenterol 2020 Nov-Dec;33(6):656-660. Epub 2020 Sep 16.

Department of Medicine, Division of Gastroenterology, Creighton University/St. Joseph's Hospital and Medical Center, Phoenix, AZ (Kambiz S. Kadkhodayan), USA.

Background: Patients with ascites resulting from chronic debilitating diseases often require non-oral enteral nutrition and undergo placement of a percutaneous endoscopic gastrostomy (PEG) tube. The aim of our study was to assess the nationwide trends and outcomes of PEG tube placement among patients with ascites.

Methods: Using the Nationwide Inpatient Sample (NIS), we conducted a retrospective analysis of adult patients (≥18 years) who underwent PEG tube placement (n=789,167) from 2010-2014. Read More

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September 2020

Percutaneous endoscopic gastrostomy; success and outcome of a novel modality for enteral nutrition.

J Pak Med Assoc 2020 Oct;70(10):1795-1798

Department of Gastroenterology & Hepatology, Patel Hospital, Karachi, Pakistan.

Objective: To determine the indications and complications of percutaneous endoscopic gastrostomy tube.

Methods: The retrospective audit study was conducted at the Department of Gastroenterology, Endoscopy Unit, Patel Hospital, Karachi, and comprised data of patients aged 4-95 years who underwent placement of percutaneous endoscopic gastrostomy under conscious sedation and for patients under 18 years of age having obtained anaesthesia fitness, under general anaesthesia, from August, 2008, to July, 2018. Pre-procedure treatment and follow-up was noted on a structured proforma. Read More

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October 2020

Safety and durability of PEG-J: a single-centre experience.

Scand J Gastroenterol 2020 Nov 6;55(11):1377-1380. Epub 2020 Oct 6.

Department of Internal Medicine and Digestive Endoscopy Unit, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.

Introduction: Although percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) is currently indicated in a variety of conditions, limited data are available regarding its safety and the best timing for its replacement. We herein describe a single-centre cohort of patients who underwent PEG-J placement or replacement to assess the short- and long-term safety of the procedure.

Methods: Demographic and procedure-related data regarding all patients undergoing a PEG-J procedure between March 2010 and 2020, either first placement or any replacement, at the Endoscopy Unit of a University Hospital in Northern Italy (IRCCS Policlinico San Matteo, Pavia, Italy), were retrospectively collected. Read More

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November 2020

Safety of endoscopic gastrostomy tube placement compared with radiologic or surgical gastrostomy: nationwide inpatient assessment.

Gastrointest Endosc 2021 May 12;93(5):1077-1085.e1. Epub 2020 Sep 12.

Division of Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, Missouri, USA.

Background And Aims: A gastrostomy tube is often required for inpatients requiring long-term nutritional access. We compared the safety and outcomes of 3 techniques for performing a gastrostomy: percutaneous endoscopic gastrostomy (PEG), fluoroscopy-guided gastrostomy by an interventional radiologist (IR-gastrostomy), and open gastrostomy performed by a surgeon (surgical gastrostomy).

Methods: Using the Nationwide Readmissions Database, we identified hospitalized patients who underwent a gastrostomy from 2016 to 2017. Read More

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Gastric Outlet Obstruction due to Malposition of Gastrostomy Tube: A Rare and Commonly Misdiagnosed Condition.

Case Rep Gastroenterol 2020 May-Aug;14(2):409-414. Epub 2020 Jul 30.

Department of Medicine, Henry J. Carter Specialty Hospital and Nursing Facility, New York, New York, USA.

Nearly all disease processes worsen with malnutrition. However, providing adequate and optimal nourishment can be challenging in individuals who are not able to eat. Insertion of a gastrostomy tube is a well-established method for providing enteral access for long-term nutritional support. Read More

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'Re-PEGing': an endoscopic approach to inadvertent early removal of PEG tube.

J Community Hosp Intern Med Perspect 2020 Jun 14;10(3):194-198. Epub 2020 Jun 14.

Division of Gastroenterology, Rochester General Hospital, Rochester, NY, USA.

Inadvertent removal of percutaneous endoscopic gastrostomy (PEG) tube shortly after placement creates the potential for gastric perforation and requires immediate attention. This problem has been addressed in the past with either observation or surgery. We describe our experience with the alternative approach of semi-urgent 're-PEGing'. Read More

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Early Buried Bumper Syndrome: A Rare Complication of Percutaneous Endoscopic Gastrostomy Tube Placement.

Cureus 2020 Jul 14;12(7):e9177. Epub 2020 Jul 14.

Gastroenterology and Hepatology, Creighton University, Omaha, USA.

Early buried bumper syndrome (BBS) is a rare complication of percutaneous endoscopic gastrostomy (PEG) tube placement where the internal bolster gets "buried" in the gastrocutaneous fistulous tract. BBS is usually a late complication with onset > four weeks of PEG placement. We present a case of early BBS presenting at day 17 after PEG tube placement where the internal bolster got embedded in the subcutaneous fat just outside the gastric wall. Read More

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Safety and outcomes of percutaneous endoscopic gastrostomy tubes in children.

Clin Nutr ESPEN 2020 08 16;38:160-164. Epub 2020 Jun 16.

School of Medicine, The University of Jordan, Amman, Jordan.

Background/aim: Gastrostomy tube feeding is indicated for children who require prolonged enteral tube feeding. Different techniques for gastrostomy tube insertion exist, and include percutaneous endoscopic gastrostomy (PEG) tube insertion. Our primary goal was to review the indications, associated complications, and outcomes from PEG tube insertion in children treated in our institution. Read More

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Bevacizumab does not increase risk of perforation in patients undergoing percutaneous endoscopic gastrostomy or jejunostomy placement.

Surg Endosc 2021 Jun 24;35(6):2976-2980. Epub 2020 Jun 24.

Gastroenterology, Hepatology and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.

Introduction: Bevacizumab is a humanized anti-vascular endothelial growth factor monoclonal antibody used in the treatment of cervical cancer, ovarian cancer, colorectal cancer, lung cancer, renal cell cancer, and recurrent glioblastomas. Its approval by US FDA was issued with a black box warning that its use has been associated with a risk of gastrointestinal (GI) tract perforation and that it should be discontinued in patients who have experienced such. The reported incidence of GI perforation in those receiving bevacizumab is as high as 3%. Read More

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Proton Therapy for Locally Advanced Oropharyngeal Cancer: Initial Clinical Experience at the University of Washington.

Int J Part Ther 2020 19;6(3):1-12. Epub 2019 Dec 19.

Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA, USA.

Purpose: Proton therapy can potentially improve the therapeutic ratio over conventional radiation therapy for oropharyngeal squamous cell cancer (OPSCC) by decreasing acute and late toxicity. We report our early clinical experience with intensity-modulated proton therapy (IMPT).

Materials And Methods: We retrospectively reviewed patients with OPSCC treated with IMPT at our center. Read More

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December 2019

Percutaneous endoscopic gastrostomy in small infants unable to swallow safely.

Pediatr Int 2020 Dec 22;62(12):1369-1373. Epub 2020 Nov 22.

Departments of, Pediatric Surgery, Goztepe Training and Research Hospital, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey.

Background: Data about percutaneous endoscopic gastrostomy (PEG) insertions in small infants are limited, and most studies include older children. We aimed to evaluate the safety of PEG placement in infants weighing ≤5 kg together with their follow-up results.

Methods: A retrospective evaluation was made of records between January 2005 and December 2019. Read More

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December 2020

Improving All-Cause Inpatient Mortality After Percutaneous Endoscopic Gastrostomy.

Dig Dis Sci 2021 May 19;66(5):1593-1599. Epub 2020 Jun 19.

Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, 110 Francis St 8e Gastroenterology, Boston, MA, 02215, USA.

Background And Aims: Percutaneous gastrostomy (PEG) is a common inpatient procedure. Prior data from National Inpatient Sample (NIS) in 2006 reported a mortality rate of 10.8% and recommended more careful selection of PEG candidates. Read More

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Percutaneous radiologically guided gastrostomy tubes: Procedural description and biomechanical comparison in a canine model.

Vet Surg 2020 Oct 14;49(7):1334-1342. Epub 2020 Jun 14.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, California, United States.

Objective: To describe the novel placement of percutaneous radiologically guided gastrostomy (PRG) tubes in a canine cadaveric model and to biomechanically compare PRG and percutaneous endoscopic gastrostomy (PEG) tube constructs.

Study Design: Descriptive and biomechanical experimental study.

Animals: Fifteen large breed (>25 kg) canine cadavers. Read More

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October 2020

Variability in the Method of Gastrostomy Placement in Children.

Children (Basel) 2020 Jun 1;7(6). Epub 2020 Jun 1.

Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI 53226, USA.

Although gastrostomy placement is one of the most common procedures performed in children, the optimal technique remains unclear. The purpose of this study was to evaluate variability in the method of gastrostomy tube placement in children in the United States. Patients <18 years old undergoing percutaneous endoscopic gastrostomy (PEG) or surgical gastrostomy (SG) (including open or laparoscopic) from 1997 to 2012 were identified using the Kids' Inpatient Database. Read More

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Dose and Volume De-Escalation for Human Papillomavirus-Positive Oropharyngeal Cancer is Associated with Favorable Posttreatment Functional Outcomes.

Int J Radiat Oncol Biol Phys 2020 07 18;107(4):662-671. Epub 2020 Apr 18.

Department of Radiation and Cellular Oncology, University of Chicago Medicine, Chicago, Illinois. Electronic address:

Purpose: To report functional outcomes for patients with human papillomavirus-positive oropharyngeal cancer treated on a phase 2 protocol of risk- and induction chemotherapy response-adapted dose and volume de-escalated radiation therapy (RT)/chemoradiation (CRT).

Methods And Materials: Patients were stratified as low risk (LR) or high risk (HR) according to T/N-stage and smoking history. Induction chemotherapy was followed by radiographic response assessment. Read More

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Conservative recovery and replacement of a ruptured percutaneous endoscopic gastrostomy tube; a case report.

BMC Gastroenterol 2020 Mar 30;20(1):82. Epub 2020 Mar 30.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.

Background: Percutaneous Endoscopic Gastrostomy (PEG) feeding tubes are frequently placed in patients to provide enteral nutrition. We report a case of a complete rupture of a PEG tube intra-abdominally with associated peritonitis after more than a month of PEG placement and utilization. To our knowledge, this is a very rare case of a complete PEG rupture with the succeeding replacement and recovery of the fractured segments conservatively. Read More

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