EARLY ACCIDENTAL DISLODGMENT OF PEG TUBES

Newer percutaneous endoscopy gastrostomy (PEG) tubes with soft interna l bolsters may be prone to accidental dislodgement or removal by patie nts. When this occurs after a mature gastrocutaneous fistula has forme d, it is of little consequence as long as a replacement tube is prompt ly reinserted before the track closes. Blind reinsertion of a replacem ent tube before the track is adequately mature may have serious conseq uences, as exemplified by a patient who developed peritonitis as a res ult of inadvertent insertion into the peritoneal cavity. We managed tw o other patients with early accidental PEG tube removal by a period of nasogastric (NG) suction, intravenous antibiotic drugs, and observati on, with a new tube placed endoscopically 7-9 days later. We review th e management of early, inadvertent dislodgement of PEG tubes.