PDF herunterladen
Endoscopy 2007; 39(8): 686-691
DOI: 10.1055/s-2007-966604
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Ultrasound-guided percutaneous endoscopic gastrostomy in patients with negative diaphanoscopy

K.  Schlottmann1 , F.  Klebl1 , R.  Wiest1 , S.  Grüne1 , F.  Kullmann1 , J.  Schölmerich1 , D.  Schacherer1
  • 1Department of Internal Medicine I, University Hospital of Regensburg, Germany
Weitere Informationen

Publikationsverlauf

eingereicht 6 August 2006

akzeptiert 17 January 2007

Publikationsdatum:
30. Juli 2007 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Introduction

The first percutaneous endoscopic gastrostomy (PEG) was performed in 1979 in a 4.5-month-old child with inadequate oral intake. Since its introduction in 1980 [1] [2], PEG has become a standard procedure by means of which to ensure long-term enteral feeding in patients in critical care or with neurological disorders who are not able to swallow [3]. Considerable progress has been made in techniques for the placement of the tubes for enteral nutrition. Consequently, PEG has replaced surgical gastrostomy as the procedure of choice in these patients. Sonographically or radiologically guided gastrostomies are alternatives which are employed especially in patients with contraindications to PEG [4] [5] [6]. Failure of diaphanoscopy is regarded as a contraindication to PEG [7]. Since 2002 we have been using ultrasonography at our institution to identify the causes of failure of diaphanoscopy and to guide PEG placement. We describe the technique of ultrasound-guided PEG placement in patients in whom transillumination is impossible.

References

  • 1 Ponsky J L, Gauderer M WL. Percutaneous endoscopic gastrostomy. A non-operative technique for feeding gastrostomy.  Gastrointest Endosc. 1981;  27 9-11
    PubMedSuche in Google Scholar
  • 2 Gauderer M W. Twenty years of percutaneous endoscopic gastrostomy: origin and evolution of a concept and its expanded applications.  Gastrointest Endosc. 1999;  50 879-883
    PubMedSuche in Google Scholar
  • 3 . Guidelines of the German Association of Nutritional Medicine: Enteral Feeding.  Aktuel Ernahrungsmed. 2003;  28: Suppl 1 26-35
    PubMedSuche in Google Scholar
  • 4 Vogt W, Messmann H, Lock G. et al . CT-guided percutaneous endoscopic gastrostomy: a successful method if transillumination is not possible.  Dtsch Med Wochenschr. 1996;  121 359-363
    PubMedSuche in Google Scholar
  • 5 Bleck J S, Reiss B, Gebel M. et al . Percutaneous sonographic gastrostomy: method, indications, and problems.  Am J Gastroenterol. 1998;  93 941-945
    CrossrefPubMedSuche in Google Scholar
  • 6 De Baere T, Chapot R, Kuoch V. et al . Percutaneous gastrostomy with fluoroscopic guidance: single-center experience in 500 consecutive cancer patients.  Radiology. 1999;  210 651-654
    PubMedSuche in Google Scholar
  • 7 Panzer S, Harris M, Berg W. et al . Endoscopic ultrasound in the placement of a percutaneous endoscopic gastrostomy tube in the non-transilluminated abdominal wall.  Gastrointest Endosc. 1995;  42 88-90
    CrossrefPubMedSuche in Google Scholar
  • 8 Schlottmann K, Gelbmann C, Schölmerich J, Lock G. Intercostal percutaneous ultrasound guided decompressive gastrostomy (PUG) - a case report.  Ultraschall Med. 2001;  22 153-155
    Thieme ConnectPubMedSuche in Google Scholar
  • 9 Herman L L, Hoskins W J, Shike M. Percutaneous endoscopic gastrostomy for decompression of the stomach and small bowel.  Gastrointest Endosc. 1992;  38 314-318
    CrossrefPubMedSuche in Google Scholar
  • 10 Larson D E, Burton D D, Schroeder K W, Di Magno E P. Percutaneous endoscopic gastrostomy. Indications, success, complications, and mortality in 314 consecutive patients.  Gastroenterology. 1987;  93 48-52
    CrossrefPubMedSuche in Google Scholar
  • 11 Benkov K J, Kazlow P G, Waye J D, Leleiko N S. Percutaneous endoscopic gastrostomies in children.  Pediatrics. 1986;  77 248-250
    PubMedSuche in Google Scholar
  • 12 Ponsky J L, Gauderer M W, Stellato T A. Percutaneous endoscopic gastrostomy. Review of 150 cases.  Arch Surg. 1983;  118 913-914
    PubMedSuche in Google Scholar
  • 13 Ponsky J L, Gauderer M W, Stellato T A, Aszodi A. Percutaneous approaches to enteral alimentation.  Am J Surg. 1985;  149 102-105
    CrossrefPubMedSuche in Google Scholar
  • 14 Foutch P G, Haynes W C, Ballapravalu S, Sanowski R A. Percutaneous endoscopic gastrostomy (PEG). A new procedure comes of age.  J Clin Gastroenterol. 1986;  8 10-15
    PubMedSuche in Google Scholar
  • 15 Cosentini E P, Sautner T, Gnant M. et al . Outcomes of surgical, percutaneous endoscopic, and percutaneous radiologic gastrostomies.  Arch Surg. 1998;  133 1076-1083
    CrossrefPubMedSuche in Google Scholar
  • 16 Mamel J J. Percutaneous endoscopic gastrostomy.  Am J Gastroenterol. 1989;  84 703-710
    PubMedSuche in Google Scholar
  • 17 Mequid M M, Williams L F. The use of gastrostomy to correct malnutrition.  Surg Gynecol Obstet. 1979;  149 27-32
    PubMedSuche in Google Scholar
  • 18 Cory D A, Fitzgerald J F, Cohen M D. Percutaneous nonendoscopic gastrostomy in children.  AJR Am J Roentgenol. 1988;  151 995-997
    PubMedSuche in Google Scholar
  • 19 Vargo J J, Germain M M, Swenson J A, Harrison C R. Ultrasound-assisted percutaneous endoscopic gastrostomy in a patient with advanced ovarian carcinoma and recurrent intestinal obstruction.  Am J Gastroenterol. 1993;  88 1946-1948
    PubMedSuche in Google Scholar
  • 20 Höroldt B S, Lee F KT, Gleeson D. et al . Ultrasound guidance in the placement of a percutaneous endoscopic gastrostomy (PEG): an adjuvant technique in patients with abdominal varices.  Dig Liver Dis. 2005;  37 709-712
    CrossrefPubMedSuche in Google Scholar
  • 21 Loser C, Aschl G, Hebuterne X. et al . ESPEN guidelines on artificial enteral nutrition - percutaneous endoscopic gastrostomy (PEG).  Clin Nutr. 2005;  24 848-861
    CrossrefPubMedSuche in Google Scholar
  • 22 Ponsky J L. Transilluminating percutaneous endoscopic gastrostomy.  Endoscopy. 1998;  30 621-622
    PubMedSuche in Google Scholar

K. Schlottmann, MD

Department of Internal Medicine I

University Hospital of Regensburg

93042 Regensburg

Germany

Fax: +49-941-9447004

eMail: klaus.schlottmann@klinik.uni-regensburg.de