Early accidental dislodgement of PEG tubes.
Newer percutaneous endoscopy gastrostomy (PEG) tubes with soft internal bolsters may be prone to accidental dislodgement or removal by patients. When this occurs after a mature gastrocutaneous fistula has formed, it is of little consequence as long as a replacement tube is promptly reinserted before the track closes. Blind reinsertion of a replacement tube before the track is adequately mature may have serious consequences, as exemplified by a patient who developed peritonitis as a result of inadvertent insertion into the peritoneal cavity. We managed two other patients with early accidental PEG tube removal by a period of nasogastric (NG) suction, intravenous antibiotic drugs, and observation, with a new tube placed endoscopically 7-9 days later. We review the management of early, inadvertent dislodgement of PEG tubes.
Division of Gastroenterology, University of Missouri School of Medicine, Columbia 65212.
J B
JB
Marshall
G
G
Bodnarchuk
J S
JS
Barthel
D000368:Aged; D004724:Endoscopy; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology; D016312:Treatment Refusal