Endoscopic Gastrostomy

Enteral tube feeding by percutaneous endoscopic gastrostomy tube (PEG) is being used in patients with advanced dementia, dysphagia secondary to neuromuscular diseases, cachexia from cancer, and any patient who is unable to eat for prolonged period. Thus most of the patients undergoing PEG have background severe disease, with many at risk for gastrointestinal (GI) hemorrhage. PEG tube placement is associated with major and minor complications defined by established criteria with rates ranging from 4% to 23.8% of cases . Most common are minor complications such as ileus, cellulitis,stomal leakage, buried bumper syndrome, gastric ulcer, fistulous tracts or inadvertent removal but about 4% have major complications such as aspiration, hemorrhage, peritonitis, necrotizing fasciitis, tumor implantation and death. During PEG placement acute bleeding occurs in approximately 1% of cases in patients who are on anticoagulation or have anatomic variations. It is common practice to monitor stool for GI blood loss by the fecal occult blood test (FOBT) whether in a screening setting for colorectal cancer or in the clinical workup of anemia Whether the placement of PEG tube can acutely or chronically result in a positive hemoccult test resulting in endoscopy to establish a GI source of bleeding, is unknown. With this in mind, we retrospectively evaluated effect of PEG tube placement on FOBT result.

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Last date updated on September, 2024