audit of indications and complications of percutaneous endoscopic gastrostomy

ABSTRACT

To evaluate the indications and complication rate in fifty consecutive patients in whom percutaneous endoscopic gastrostomy [PEG] was attempted. A descriptive study. Fifty consecutive adults referred to our unit for consideration for primary percutaneous endoscopic gastrostomy feeding between November 1999 and October 2001 at The Aga Khan University Hospital, Karachi and Isra University Hospital, Hyderabad were evaluated prospectively. PEG insertions were successful in all fifty patients [29 Males, 21 Females]. The indications for PEG were neurogenic [80%], recurrent aspiration, not the gastric contents [8%], head and neck tumors [6%], esophageal tumor [4%] and dermatomyositis [2%]. Ninety six percent of the patients had the procedure as inpatients while 4% were outpatients when the procedure was performed. Eighty percent of the patients had at least one follow-up after the tube insertion. Major complications were peritonitis [2%] and aspiration of gastric contents [4%]. Minor complications were PEG site infection [16%], accidental tube removal [10%], PEG migration [6%] and PEG blockage [4%]. One patient died due to peritonitis. Oral feed was resumed in 12% of the patients and the tube was removed subsequently. PEG is a feasible and safe procedure in our set up. It provides adequate feeding support and has low mortality rate even in patients, debilitated secondary to their underlying disease