IMAGING OF PERCUTANEOUS TUBE GASTROSTOMIES - SPECTRUM OF NORMAL AND ABNORMAL FINDINGS

Enteral alimentation is a crucial component of care for the malnourish ed patient who cannot eat. Until recently, long-term alimentation was delivered through nasogastric tubes or gastrostomy tubes placed at sur gery. In the past few years, percutaneous endoscopic gastrostomy (PEG) has almost completely supplanted these traditional methods. PEG is a safer and better-tolerated procedure. The advantages of PEG over nasog astric tubes include greater social acceptance and improved cosmetic a ppearance, increased ease of feedings, and decreased nasal alar deform ities and gastroesophageal reflux. Complications are less common with PEG than with open gastrostomy but still occur in as many as 15% of ca ses [1-3],.Percutaneous gastrostomies performed using fluoroscopic gui dance have complications in approximately 10% of cases [4]. Despite a rapid increase in the use of percutaneous gastrostomies and their plac ement by radiologists [4], few published reports have described imagin g findings after the placement of such tubes. This pictorial essay ill ustrates a spectrum of normal and abnormal imaging findings observed w ith the use of PEG tubes, including tube migration and misplacement, i nfection, tumor seeding along the PEG tube track, and a variety of gas tric wall defects and pseudomasses.