Complications After PEG Tube Placement
Yes, there are several potential complications following PEG tube placement, with local wound infection being the most frequent (occurring in approximately 15% of cases), though most complications can be prevented or managed with proper aftercare and monitoring. 1
Common Complications and Their Management
Local Wound Infection
- Local wound infection is the most frequent complication, occurring in approximately 15% of cases 1
- Less than 5 mm of reddening around the outer stoma canal is common and often movement-related rather than a true sign of infection 1
- Monitor for peristomal abdominal pain, fever (sometimes with transient leukocytosis), or leakage of stomach contents from the puncture canal in the initial days after placement 1
- If gastric contents are leaking, use a hydrocolloid wafer as a keyhole dressing for skin protection 1, 2
Buried Bumper Syndrome
- This serious complication can be prevented through proper aftercare, including regular tube mobilization during dressing changes 1, 2
- To prevent this, push the tube approximately 2-3 cm ventrally and carefully pull it back up to the resistance of the internal fixation flange during each dressing change 1, 2
Tube Occlusion
- Tube occlusion can be prevented by flushing the tube with approximately 40 ml of drinking or still mineral water after each feed or medication administration 1, 2
- Regular flushing prevents residue buildup and maintains tube patency 2
Other Potential Complications
- Bleeding, erythema, secretion, induration, or allergic skin reactions at the wound site 1
- Nodule rupture (in the context of thyroid ablation procedures, NSAIDs are recommended for prevention/treatment) 1
Critical Prevention Strategies
Daily Wound Care Protocol
- The first dressing change should be performed the morning after PEG placement 2
- Perform daily sterile dressing changes and local disinfection until granulation of the stoma canal occurs (usually days 1-7) 2
- During each dressing change, open the fixation plate, remove the tube from the groove, and thoroughly inspect the wound area for signs of complications 1, 2
Long-term Maintenance
- After initial wound healing (1-2 weeks), cleansing and dressing should be performed every 2-3 days 2
- Washing with soap and water or showering is possible after initial wound healing; always remove dressings before washing, rinse away residual soap, and dry the tube well before applying a new dressing 2
Important Clinical Pitfall
A common pitfall is assuming all redness indicates infection. Less than 5 mm of reddening around the outer stoma canal is often movement-related and does not require antibiotic treatment 1. Only pursue infection management when accompanied by fever, purulent drainage, or systemic signs of infection.