Introduction:

Percutaneous gastrostomy (PEG) and percutaneous jejunostomy (PEJ) are procedures used to provide enteral nutrition to individuals who are unable to consume adequate oral intake. These minimally invasive techniques involve the placement of feeding tubes directly into the stomach (gastrostomy) or the jejunum (jejunostomy) through the abdominal wall. This comprehensive article aims to provide a thorough understanding of percutaneous gastrostomy and jejunostomy, including their indications, the procedure involved, and the care required for these feeding tubes.

Indications for Percutaneous Gastrostomy and Jejunostomy:

Percutaneous gastrostomy and jejunostomy may be indicated in the following situations:

• Inability to consume adequate oral intake: These procedures are commonly performed in individuals with conditions such as stroke, head and neck cancer, neurologic disorders, or severe malnutrition who cannot meet their nutritional needs orally.
• Prolonged enteral nutrition: Gastrostomy and jejunostomy tubes are suitable for long-term enteral feeding, providing a reliable means of delivering nutrition directly into the gastrointestinal tract.
• Palliative care: These procedures may be performed in individuals with advanced illness or poor prognosis to improve their comfort and quality of life by ensuring adequate nutrition.

Procedure of Percutaneous Gastrostomy and Jejunostomy:

The percutaneous gastrostomy and jejunostomy procedures involve several key steps:

• Pre-procedure evaluation: The patient's medical history, nutritional status, and ability to tolerate the procedure are assessed.
• Anesthesia: Local anesthesia and sedation are administered to ensure comfort during the procedure.
• Tube placement: Using image guidance, a feeding tube is inserted through a small incision in the abdominal wall and advanced into the stomach (for gastrostomy) or the jejunum (for jejunostomy).
• Tube fixation: The external portion of the feeding tube is secured to the abdominal wall to prevent dislodgment.
• Confirmation and testing: The placement of the tube is confirmed by visualization or radiographic examination, and the tube's functionality is tested by flushing it with water or administering enteral feeds.

Care of Percutaneous Gastrostomy and Jejunostomy Tubes:

Proper care of the gastrostomy or jejunostomy tube is crucial to prevent complications and maintain its functionality. The following care guidelines are typically recommended:

• Tube site care: The skin around the tube site should be kept clean and dry, and inspected regularly for signs of infection, such as redness, swelling, or discharge.
• Tube flushing and medication administration: The tube should be flushed with water before and after each feeding or medication administration to prevent blockages. Medications should be administered as directed by the healthcare provider.
• Feeding administration: Enteral feeds should be administered as per the prescribed schedule, following proper hygiene and safety precautions.
• Regular follow-up: Routine follow-up appointments with healthcare providers are essential to monitor the tube site, assess nutritional status, and make any necessary adjustments to the feeding regimen.

Complications and Risks:

While percutaneous gastrostomy and jejunostomy procedures are generally safe, there are potential risks and complications, including:

• Infection at the tube site
• Dislodgement or accidental removal of the tube
• Leakage around the tube site
• Tube blockage or malfunction
• Aspiration pneumonia if proper positioning and precautions are not followed

Conclusion:

Percutaneous gastrostomy and jejunostomy procedures are valuable interventions for individuals who require long-term enteral nutrition support. By understanding their indications, the procedure involved, and the care required, patients and caregivers can ensure the optimal management of enteral feeding, leading to improved nutritional status and overall well-being.

Hashtags: #PercutaneousGastrostomy #PercutaneousJejunostomy #EnteralNutrition #FeedingTube