title: Ultrasound guidance in the placement of a percutaneous endoscopic gastrostomy (PEG): an adjuvant technique in patients with abdominal wall varices?
abstract: Malnutrition in patients with liver disease is common. As a result, enteral feeding may be indicated. Percutaneous endoscopic gastrostomy insertion is rarely performed because the presence of varices is considered to be a contraindication. We report a case of percutaneous endoscopic gastrostomy insertion in a patient with both gastric and oesophageal varices. The use of abdominal ultrasound may provide an adjuvant tool for percutaneous endoscopic gastrostomy insertion. This novel technique may minimise the risk of complications in selected patients.
authors.affiliation: Department of Radiology, Gastroenterology and Hepatology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. bsrhoeroldt@doctors.org.uk
authors.forename: B S
authors.initials: BS
authors.lastname: Höroldt
authors.forename: F K T
authors.initials: FK
authors.lastname: Lee
authors.forename: D
authors.initials: D
authors.lastname: Gleeson
authors.forename: M E
authors.initials: ME
authors.lastname: McAlindon
authors.forename: D S
authors.initials: DS
authors.lastname: Sanders
mesh_terms: D034861:Abdominal Wall / Q000098:blood supply / Q000473:pathology; D000328:Adult; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D011183:Postoperative Complications; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014648:Varicose Veins / Q000209:etiology