Adapting PEG Techniques to Complex Clinical Scenarios

Abstract Text We present two cases in which we were consulted for PEG placement. The first case involves a 65-year-old female patient with Parkinson's disease, sleeve gastrectomy, and hepatic steatosis, who experienced a failed first attempt at PEG-J placement. The successful second attempt was laparoscopically assisted, revealing a macronodular cirrhotic liver covering the remaining stomach. The second case involves a 68-year-old female patient with a stenotic cervical esophageal tumor who had a push-PEG placed three months prior. The PEG balloon could not be deflated due to viscous, opaque fluid inside, and its replacement required endoscopic puncture of the balloon using a biopsy forceps. Subsequently, a larger-diameter PEG was placed, which necessitated gastrostomy dilation with bougies.

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Publication History

Article published online:
27 March 2025