Purpose: Percutaneous endoscopic gastrostomy was first described in 1980. It is generally
excepted as method of choice for providing enteral nutrition in dysphagic patients.
Overall complication rates are 27 to 39% at two months in several surveys. Diaphanization
is assessed as not necessary in advance of the intervention. Our question was, whether
pre-endoscopic abdominal ultrasound is helpful to avoid complications.
Material and methods: From March 2010 to February 2013 we performed abdominal sonography in 125 of 568
patients, who were sent for percutaneous gastrostomy to our endoscopic unit (Group
A). 69 Patients with ENT- tumors received their percutaneous gastrostomy during surgical
resection in the operation theatre without sonography (Group B).
Results: In group A we examined 75 male and 50 female patients. Age ranged from 32 to 88 years
in male patients (average 67.57 years), 45 to 95 years in female patients (average
77.8 years). Most of them had neurologic disorders (head injury or stroke) or dementia,
only few had tumors of head and neck. We found four cases of ascites (3.2%), so that
percutaneous endoscopic gastrostomy was contraindicated, and one upside down stomach
(0.08%), which resulted in primary transthoracic percutaneous gastrostomy. Group B
consisted of 69 patients (52 male, 38 – 78 years, average 55.6 years, 17 female, 38
– 82 years, average age 55.5 years). Here we found two ascites fistulas in male patients
due to not detected liver cirrhoses, and one failed puncture due to upside down stomach.
Conclusion: In our study, preendoscopic ultrasound discovered contraindications against percutaneous
gastrostomy in 3.2% of our patients. In one case we avoided an incorrect attempt,
in four cases we avoided endoscopic interventions in a situation, which was likley
for complications. We recommend further studies concerning this topic.
