Download PDF
Semin intervent Radiol
DOI: 10.1055/s-0044-1801290
Special Issue - Invited Article

Complications of Gastrostomy Tube Placement

Gail Peters
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Ross Bittman
2   TRA Medical Imaging, Tacoma, Washington
,
Tina Sankhla
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Gastrostomy tube placement is a common medical procedure performed endoscopically, surgically, or with image guidance in interventional radiology. It is indicated for nutritional supplementation in those with inadequate oral intake and for gastric decompression in the setting of intestinal obstruction. For optimal outcomes, preprocedural clinical evaluation, imaging workup, meticulous technique during placement, and close clinical follow-up are essential. Complications are usually minor but not uncommon. They may occur during placement, in the immediate postoperative period, and throughout the time the tube is in place. This article will review the indications, contraindications, and complications of percutaneous gastrostomy tube placement. Major and minor complications will be illustrated along with tips and mitigation strategies employed to avoid and treat them.

Keywords

gastrostomy - enteral nutrition - feeding tube - G-tube - interventional radiology


Publication History

Article published online:
30 January 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Bischoff SC, Austin P, Boeykens K. et al. ESPEN guideline on home enteral nutrition. Clin Nutr 2020; 39 (01) 5-22
    CrossrefPubMedSearch in Google Scholar
  • 2 Gauderer MW, Ponsky JL, Izant Jr RJ. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980; 15 (06) 872-875
    CrossrefPubMedSearch in Google Scholar
  • 3 Preshaw RM. A percutaneous method for inserting a feeding gastrostomy tube. Surg Gynecol Obstet 1981; 152 (05) 658-660
    PubMedSearch in Google Scholar
  • 4 Itkin M, DeLegge MH, Fang JC. et al; Interventional Radiology and American Gastroenterological Association, American Gastroenterological Association Institute, Canadian Interventional Radiological Association, Cardiovascular and Interventional Radiological Society of Europe. Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, with endorsement by Canadian Interventional Radiological Association (CIRA) and Cardiovascular and Interventional Radiological Society of Europe (CIRSE). J Vasc Interv Radiol 2011; 22 (08) 1089-1106
    CrossrefPubMedSearch in Google Scholar
  • 5 Boeykens K, Duysburgh I. Prevention and management of major complications in percutaneous endoscopic gastrostomy. BMJ Open Gastroenterol 2021; 8 (01) e000628
    CrossrefPubMedSearch in Google Scholar
  • 6 Patel IJ, Rahim S, Davidson JC. et al. Society of Interventional Radiology Consensus Guidelines for the periprocedural management of thrombotic and bleeding risk in patients undergoing percutaneous image-guided interventions—Part II: Recommendations: endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe. J Vasc Interv Radiol 2019; 30 (08) 1168-1184.e1
    CrossrefPubMedSearch in Google Scholar
  • 7 Chehab MA, Thakor AS, Tulin-Silver S. et al. Adult and pediatric antibiotic prophylaxis during vascular and IR procedures: a Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Association for Interventional Radiology. J Vasc Interv Radiol 2018; 29 (11) 1483-1501.e2
    CrossrefPubMedSearch in Google Scholar
  • 8 Campoli PM, de Paula AA, Alves LG, Turchi MD. Effect of the introducer technique compared with the pull technique on the peristomal infection rate in PEG: a meta-analysis. Gastrointest Endosc 2012; 75 (05) 988-996
    CrossrefPubMedSearch in Google Scholar
  • 9 Clayton S, DeClue C, Lewis T. et al. Radiologic versus endoscopic placement of gastrostomy tube: comparison of indications and outcomes at a tertiary referral center. South Med J 2019; 112 (01) 39-44
    CrossrefPubMedSearch in Google Scholar
  • 10 Wojtowycz MM, Arata Jr JA, Micklos TJ, Miller Jr FJ. CT findings after uncomplicated percutaneous gastrostomy. AJR Am J Roentgenol 1988; 151 (02) 307-309
    CrossrefPubMedSearch in Google Scholar
  • 11 Taheri MR, Singh H, Duerksen DR. Peritonitis after gastrostomy tube replacement: a case series and review of literature. JPEN J Parenter Enteral Nutr 2011; 35 (01) 56-60
    CrossrefPubMedSearch in Google Scholar
  • 12 Bream P. Balloon assisted gastrostomy (BAG). YouTube. November 26, 2014. Accessed August 4, 2024 at: https://www.youtube.com/watch?v=GuF7BYW2Hm0&rco=1
    PubMed
  • 13 Miller KR, McClave SA, Kiraly LN, Martindale RG, Benns MV. A tutorial on enteral access in adult patients in the hospitalized setting. JPEN J Parenter Enteral Nutr 2014; 38 (03) 282-295
    CrossrefPubMedSearch in Google Scholar
  • 14 American Geriatrics Society Ethics Committee and Clinical Practice and Models of Care Committee. American Geriatrics Society feeding tubes in advanced dementia position statement. J Am Geriatr Soc 2014; 62 (08) 1590-1593
    CrossrefPubMedSearch in Google Scholar
  • 15 Crosby J, Duerksen D. A retrospective survey of tube-related complications in patients receiving long-term home enteral nutrition. Dig Dis Sci 2005; 50 (09) 1712-1717
    CrossrefPubMedSearch in Google Scholar
  • 16 Cyrany J, Rejchrt S, Kopacova M, Bures J. Buried bumper syndrome: a complication of percutaneous endoscopic gastrostomy. World J Gastroenterol 2016; 22 (02) 618-627
    CrossrefPubMedSearch in Google Scholar
  • 17 Forner D, Mok F, Verma N. et al. Placement technique impacts gastrostomy tube-related complications amongst head and neck cancer patients. Oral Oncol 2022; 130: 105903
    CrossrefPubMedSearch in Google Scholar