MyMedR

Percutaneos endoscopic gastrostomy

Tan YM, Goh KL

JUMMEC, 1996;1:29-32.

Matched MeSH terms: Gastrostomy

Fulltext Creative treatment of early buried bumper syndrome

Taher MM, Kosai NR, Gendeh HS

Ann R Coll Surg Engl, 2014 Nov;96(8):621-2.

PMID: 25350188 DOI: 10.1308/rcsann.2014.96.8.621b

Matched MeSH terms: Gastrostomy/adverse effects*; Gastrostomy/instrumentation*

Hemoperitoneum after accidental dislodgement and subsequent replacement of PEG tube

Tan YM, Abdullah M, Goh KL

Gastrointest Endosc, 2001 May;53(6):671-3.

PMID: 11323604

Matched MeSH terms: Gastrostomy/instrumentation*; Gastrostomy/methods*

Fulltext Intussusception as a complication of gastrostomy tube: a case report

Hussain M, Thambidorai CR

Med J Malaysia, 2000 Jun;55(2):271-2.

PMID: 19839160

A neurologically impaired child who had fundoplication and gastrostomy done for gastroesophageal at the age of three, presented two years later with intestinal obstruction. She underwent laparotomy and was found to have antegrade jejuno-jejunal intussusception. Intussusception is an unusual but recognised complication of gastrostomy tube placement.

Matched MeSH terms: Gastrostomy/adverse effects*

An unexpected cause of transient diarrhea

Chuah YY, Lee YY, Tsai TJ

Postgrad Med, 2017 May;129(4):488-490.

PMID: 28335674 DOI: 10.1080/00325481.2017.1311198

Migration of percutaneous endoscopic gastrostomy (PEG) tube to colon with gastro-colonic-cutaneous fistula formation is a rare complication of the procedure. Transient episodic diarrhea following each PEG tube feeding is typical of this complication. We present a 72-year-old man with cerebrovascular disease and scoliosis who encountered episodes of transient diarrhea after each PEG tube feeding. His diarrhea was refractory to medications. Colonoscopy demonstrated a mal-positioned PEG in the transverse colon. Computed tomogram (CT) of abdomen further confirmed the finding. After removal of the migrated PEG, his diarrhea had ceased completely. The gastro-colonic-cutaneous fistula was further managed with endoscopic clipping method with no complications encountered during follow up.

Matched MeSH terms: Gastrostomy/instrumentation*

Systematic review of qualitative and quantitative studies on the attitudes and barriers to percutaneous endoscopic gastrostomy feeding

Jaafar MH, Mahadeva S, Morgan K, Tan MP

Clin Nutr, 2016 12;35(6):1226-1235.

PMID: 27181526 DOI: 10.1016/j.clnu.2016.04.019

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is now commonly used in long-term care and community settings. However, regional variations exist in the acceptability of PEG tube feeding with long-term nasogastric feeding still commonplace in many Asian nations.

AIMS: To evaluate the evidence relating to attitudes towards PEG feeding and to determine potential barriers to the acceptance of PEG tube feeding.

METHODS: We searched Ovid MEDLINE, EMBASE, the Cochrane Library, Web of Science and CINAHL databases. The search for the studies was performed without restrictions by using the terms "PEG", "percutaneous endoscopic gastrostomy", "enteral feeding", "attitude", "perception" and "opinion". Qualitative and quantitative studies were included. Quality of studies was assessed with the Alberta checklists.

RESULTS: From 981 articles, 17 articles were included in the final analysis. Twelve qualitative and four quantitative studies were considered of good quality. Seven of the 14 studies reported positive attitudes towards PEG. Three major themes were identified in terms of barriers to PEG feeding: lack of choice (poor knowledge, inadequate competency and skills, insufficient time given, not enough information given, lack of guidelines or protocol, resource constraints), confronting mortality (choosing life or death, risk of procedure) and weighing alternatives (adapting lifestyle, family influences, attitudes of healthcare professionals (HCPs), fear and anxiety).

CONCLUSIONS: Only half of the reviewed studies reported positive perceptions towards PEG feeding. The themes identified in our systematic review will guide the development of interventions to alter the current attitudes and barriers towards PEG tube feeding.

Matched MeSH terms: Gastrostomy/education; Gastrostomy/methods*

Fulltext A prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with acute dysphagic stroke

Hamidon BB, Abdullah SA, Zawawi MF, Sukumar N, Aminuddin A, Raymond AA

Med J Malaysia, 2006 Mar;61(1):59-66.

PMID: 16708735 MyJurnal

Dysphagia following stroke is common problem and is of particular concern because of its potental for malnutrition. Nasogastric (NG) and percutaneous endoscopic gastrostomy (PEG) tube feeding are recognized methods for nutritional support for patients with persistent neurologic dysphagia. However, the former is associated with tube dislodgement and blockage that might compromise the patients' nutritional status. There have been few randomized prospective studies to date comparing the efficacy and safety of these 2 modes of dysphagia management in stroke patients. The objective of this study was to compare PEG with NG tube feeding after acute dysphagic stroke in terms of nutritional status and treatment failure. This was a randomized prospective clinical trial. A total of 23 consecutive patients who fulfilled the criteria were recruited from the medical wards in Hospital Universiti Kebangsaan Malaysia. The diagnosis of stroke (acute cerebral infarct) was based on clinical and brain computed tomographic (CT scan) findings; and the diagnosis of dysphagia was done clinically by using the 'swallowing test'. At recruitment, upper-arm skin fold thickness (triceps and biceps) and mid-arm circumference were measured; and blood was drawn for serum albumin level. They were then followed up at 4 weeks where the above tests were repeated. A total of 22 patients completed the study (12 patients in the NG group and 10 patients in the PEG group). Serum albumin levels (p = 0.045) were significantly higher in the PEG as compared to the NG group at 4 weeks post-intervention. There were statistically significant improvements in serum albumin level (p = 0.024) in the PEG group; and statistically significant reductions in serum albumin level (p = 0.047) in the NG group 4 weeks after the intervention. However, there were no significant differences in anthropometric parameters between the two groups and no significant changes in these parameters for each group 4 weeks after the intervention. Treatment failure occurred in 5 out of 10 patients (50.0%) in the NG group, but none in PEG group (p = 0.036). PEG tube feeding is more effective than NG tube feeding in improving the nutritional status (in terms of the serum albumin level) of patients with dysphagic stroke. NG tube feeding, in fact, reduced the nutritional status (in terms of the serum albumin level) of the patients.

Matched MeSH terms: Gastrostomy/instrumentation; Gastrostomy/methods*

Fulltext Combined laparoscopic cholecystectomy and drainage of pancreatic pseudocyst: a case report and review of current management

Che Jusoh MA, Hassan J, Mohd Nor R, Kong CF, Zahirah Awang NF

Med J Malaysia, 2013 Jun;68(3):273-4.

PMID: 23749024 MyJurnal

Pancreatic pseudocyst is a well recognized complication of acute or chronic pancreatitis. Active treatment (surgical or endoscopic) has been recommended if the pseudocyst persists for more than 6 weeks after the diagnosis. Open trans-abdominal drainage was initially the mainstay treatment for it. However, over the past decade, laparoscopic techniques have been developed to provide patient with minimal access alternative. We report a case of a large symptomatic pseudocyst which developed following attack of severe gallstone pancreatitis. Laparoscopic cholecystectomy and cysto-gastrostomy were done at the same sitting. The operative technique is briefly explained.

Matched MeSH terms: Gastrostomy

Open gastrostomy under ultrasound-guided bilateral oblique subcostal transversus abdominis plane block: a case series

Hasan MS, Ling KU, Vijayan R, Mamat M, Chin KF

Eur J Anaesthesiol, 2011 Dec;28(12):888-9.

PMID: 21857518 DOI: 10.1097/EJA.0b013e32834ad9bd

Matched MeSH terms: Gastrostomy/methods*

Jejunal perforation complicating PEG insertion in a child

Meng Boey CC, Goh KL, Sithasanan N, Goh DW

Gastrointest Endosc, 2002 Apr;55(4):607-8.

PMID: 11923788

Matched MeSH terms: Gastrostomy/adverse effects*

A rare complication of endoscopic cystgastrostomy

Lee J, Sachithanandan S, Raman K

Gastroenterology, 2011 Nov;141(5):e1-2.

PMID: 21946349 DOI: 10.1053/j.gastro.2010.07.062

Matched MeSH terms: Gastrostomy/adverse effects*

Antibiotic prophylaxis tailored to local organisms reduces percutaneous gastrostomy site infection

Mahadeva S, Sam IC, Khoo BL, Khoo PS, Goh KL

Int J Clin Pract, 2009 May;63(5):760-5.

PMID: 19222613 DOI: 10.1111/j.1742-1241.2008.01881.x

Current recommendations for the choice of antibiotic prophylaxis prior to percutaneous endoscopic gastrostomy (PEG) insertion may not be suitable in all situations.

Matched MeSH terms: Gastrostomy/adverse effects*

Perceptions of Healthcare Professionals on the Usage of Percutaneous Endoscopic Gastrostomy in a Teaching Hospital from a Middle-Income South East Asian Country

Jaafar MH, Mahadeva S, Subramanian P, Tan MP

J Nutr Health Aging, 2017;21(4):473-479.

PMID: 28346575 DOI: 10.1007/s12603-016-0774-2

OBJECTIVE: To explore the perceptions of healthcare professionals' (HCPs) in a South East Asian nation towards percutaneous endoscopic gastrostomy (PEG) feeding.

DESIGN: Semi-structured, qualitative interviews.

SETTINGS: A teaching hospital in Kuala Lumpur, Malaysia.

PARTICIPANTS: A total of 17 healthcare professionals aged 23-43 years, 82% women.

RESULTS: Thematic analysis revealed five themes that represent HCPs' perceptions in relation to the usage of PEG feeding: 1) knowledge of HCPs, 2) communication, 3) understanding among patients, and 4) financial and affordability.

CONCLUSION: The rationale for reluctance towards PEG feeding observed in this regions was explained by lack of education, knowledge, communication, team work, and financial support. Future studies should assess the effects of educational programmes among HCPs and changes in policies to promote affordability on the utilization of PEG feeding in this region.

Matched MeSH terms: Gastrostomy/methods*

Fulltext Percutaneous endoscopic gastrostomy in patients with ventriculoperitoneal shunt

Vui HC, Lim WC, Law HL, Norwani B, Charles VU

Med J Malaysia, 2013 Oct;68(5):389-92.

PMID: 24632867

INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) placement in patients with ventriculo-peritoneal shunt (VPS) may be associated with complications. This study reports our experience of PEG in patients with VPS.

MATERIALS AND METHODS: Consecutive patients undergoing PEG insertion in a gastroenterology unit over 18 month's period were retrospectively analyzed. All patients were evaluated by an attending gastroenterologist for fitness for procedure. Instructions were given for routine antibiotic prophylaxes before the procedure and continued for 48 hours. Patients were followed for immediate complications in particular, wound infection, signs of meningitis, deterioration in neurological state and shunt malfunction. Post discharge, patients were given routine follow-up for review.

RESULTS: Of 86 patients who had PEG inserted during the study period, 14 had VPS including 2 of which had VPS after PEG. The main common indications for VPS were intracerebral bleed and head trauma and for PEG were requirement of long term enteral feeding. Twelve patients had PEG at a mean interval of 61 days (range 1-187 days) after VPS. Of these, eight received prophylactic antibiotic or were on antibiotic for other indications before PEG. Two patients developed mild PEG site infections within a week of insertions, including one patient who was not given antibiotic prophylaxis, both treated successfully with antibiotics. The latter patient developed worsening hydrocephalus secondary to VPS blockage. At a mean follow-up period was 140 days (range 20-570 days), there were no death or further complications encountered.

CONCLUSIONS: Although safe in the majority of patients with VPS, PEG infection can lead to intracranial complications. We recommend antibiotic prophylaxis for VPS patients before PEG.

Matched MeSH terms: Gastrostomy

Abdominal wall necrotising fasciitis: A rare but devastating complication of the percutaneous endoscopic gastrostomy procedure

Mohd Said MR, Abdul Rani R, Raja Ali RA, Ngiu CS

Med J Malaysia, 2017 02;72(1):77-79.

PMID: 28255151 MyJurnal

Percutaneous Endoscopic Gastrostomy (PEG) tubes were often offered to patients requiring long term enteral feeding. Even though the procedure is relatively safe, it is associated with various complications such as peritonitis or even death.1 We presented a case of a 54-year-old gentleman with underlying ischemic stroke and pus discharges from a recently inserted PEG tube. Computed Topography (CT) scan confirmed abdominal wall necrotising fasciitis complicated with hyperosmolar hyperglycaemia state (HHS) and later succumbed after 48 hours of admission. Our case illustrated the rare complication related to the insertion of PEG tube; abdominal wall necrotising fasciitis that was associated with mortality.

Matched MeSH terms: Gastrostomy

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