Patients presenting with failure to thrive, feeding
difficulties, and poor weight gain often require
long-term enteric feeding to ensure they
receive the supplemental nutrition necessary to
maintain a proper body weight. A percutaneous endoscopic
gastrostomy (PEG) tube is a common feeding
tube surgically placed into a patient’s stomach. As with
all surgeries, complications can occur. If concerns arise
regarding the positioning of the gastrostomy tube retention
device, which could be either a dome, disc, or
retention balloon, the tube should be evaluated under
fluoroscopic guidance.
First described in 1980, PEG tubes are the initial
choice for long-term enteric feeding access.1,2 Although
endoscopic guidance is used to confirm placement of
the intraluminal retention device of the PEG tube, its
course through the abdominal cavity cannot be seen
in its entirety. PEG tube placement is considered a safe
procedure, but complications such as a pneumoperitoneum
(gas in the abdominal cavity), bleeding, gastrocolocutaneous
fistula (a connection between the
stomach, colon, and skin due to accidental placement),
and injuries to the colon, small bowel, liver, or spleen
could occur.3