From the Guidelines
A Percutaneous Endoscopic Gastrostomy (PEG) tube malfunction can lead to serious complications, including infection, granulation tissue, and mechanical issues such as blockage or dislodgement.
Implications of PEG Tube Malfunction
- Infection: A common complication of PEG tube placement, which can be prevented with proper wound care and aseptic technique 1.
- Granulation Tissue: Excessive granulation tissue can form around the gastrostomy tube, causing bleeding, pain, and other issues, and can be treated with topical antimicrobial agents, barrier films, or cauterization with silver nitrate 1.
- Mechanical Complications: Blockage or dislodgement of the tube can occur, and can be prevented with routine water flushing and proper tube care 1.
Management of PEG Tube Malfunction
- Infection Management: Topical antimicrobial agents and systemic broad-spectrum antibiotics can be used to treat site infections, and the tube should be removed if the infection cannot be resolved 1.
- Granulation Tissue Management: Treatment options include topical antimicrobial agents, barrier films, cauterization with silver nitrate, and surgical removal 1.
- Mechanical Complication Management: Routine water flushing and proper tube care can help prevent blockage and dislodgement, and a guide wire or commercially available tube declogger can be used to unblock the tube if necessary 1.
From the Research
Implications of PEG Tube Malfunction
The implications of a Percutaneous Endoscopic Gastrostomy (PEG) tube malfunction can be significant, with potential complications including:
- Minor complications such as peristomal leakage, inadvertent tube removal, and granulation tissue 2
- Major complications such as buried bumper, tube blockage, and peristomal site infection 2
- Tube dysfunction, including peritube leakage, plugging, fracture, or migration 3
- Need for tube replacement or removal 3
- Aspiration after PEG or PEJ tube placement 3
Risk Factors for Complications
Certain risk factors can increase the likelihood of complications, including:
- Old age 2
- Multimorbidity 2
- Use of inappropriate methods for PEG positioning 2
- Acute illness 4
- Short life expectancy 4
- Severe coughing 4
Strategies for Avoiding Complications
To minimize the risk of complications, it is essential to:
- Use proper PEG positioning techniques 2
- Implement adequate post-positioning patient management and surveillance 2
- Follow strict guidelines for PEG tube placement 4
- Avoid placing PEG tubes in patients with certain contraindications, such as distal enteral obstruction, severe uncorrectable coagulopathy, and hemodynamic instability 5