GASTRO/GENSURG
PEG TUBE
PromptPeg removed - factors determining if the tube should be re-sited
ResponseTime since PEG placement - if <4 weeks tract may not have matured adequately and gastric/abdominal wall may have separated - risk of tube misplacement into peritoneal cavity. Should NOT be resited in ED
Time since PEG removal - ideally should be replaced ASAP as tract will start closing within 24 hours (perhaps sooner)
Features of peritonitis
Major bleeding
Tract closure
Time since PEG removal - ideally should be replaced ASAP as tract will start closing within 24 hours (perhaps sooner)
Features of peritonitis
Major bleeding
Tract closure
PromptAlternatives if no PEG tube available
ResponseFoley catheter (large as possible)
PromptWays to confirm PEG placement if unsure
ResponseCT abdomen with contrast (?PEG contrast)
PromptComplications of PEG tubes
ResponseWound infection/ulceration/necrotising fasciitis
Bleeding
Leaking around stoma
Leaking of gastric contents into peritoneum/pneumoperitoneum
Gastric ulceration
Gastric outlet obstruction
Ileus/gastroparesis
PEG blockage
aspiration
Bleeding
Leaking around stoma
Leaking of gastric contents into peritoneum/pneumoperitoneum
Gastric ulceration
Gastric outlet obstruction
Ileus/gastroparesis
PEG blockage
aspiration