Enteral Access: A Review of Technique, Complications, and Management Strategies

Abstract

Percutaneous enteral access for nutritional support may be required for a wide host of comorbid conditions, including processes such as obstructive head and neck tumors, esophageal tumors, neurologic/neuromuscular disorders such as amyotrophic lateral sclerosis, multiple sclerosis, or stroke, chronic gastric outlet obstruction, small bowel obstruction, and motility disorders. Given this demand, it is important for providers to be aware of the complications associated with percutaneous radiologic enteral access and how to manage them. We herein provide a brief overview of complications related to enteral access, including anatomic, technical, preventative, and management considerations.

Keywords

gastrostomy - enteral - complications

Publication History

Received: 24 July 2022

Accepted: 17 January 2023

Article published online:
27 March 2023

• References

• 1 Covarrubias DA, O'Connor OJ, McDermott S, Arellano RS. Radiologic percutaneous gastrostomy: review of potential complications and approach to managing the unexpected outcome. AJR Am J Roentgenol 2013; 200 (04) 921-931
• 2 Preshaw RM. A percutaneous method for inserting a feeding gastrostomy tube. Surg Gynecol Obstet 1981; 152 (05) 658-660
• 3 Mauro M, Murphy K, Thomson K. et al. Image-Guided Interventions. 3rd ed. Elsevier; 2020
• 4 Cheng AKC, Wong SC, Wong WPM, Li YL, Cheung SCW. Winslow's pathway. Abdom Radiol (NY) 2019; 44 (01) 370-371
• 5 Sutcliffe J, Wingham A, Mceniff N, Dvorak P. et al. CIRSE Standards of Practice Guidelines on Gastrostomy. J Vasc Interv Radiol 2016; 39 (07) 973-987
• 6 Perona F, Castellazzi G, De Iuliis A, Rizzo L. Percutaneous radiologic gastrostomy: a 12-year series. Gut Liver 2010; 4 (Suppl 1, Suppl 1): S44-S49
• 7 Bankhead RR, Fisher CA, Rolandelli RH. Gastrostomy tube placement outcomes: comparison of surgical, endoscopic, and laparoscopic methods. Nutr Clin Pract 2005; 20 (06) 607-612
• 8 Ponsky JL. The development of PEG: how it was. J Interv Gastroenterol 2011; 1 (02) 88-89
• 9 Alagaratnam TT, Ong GB. Wound implantation – a surgical hazard. Br J Surg 1977; 64 (12) 872-875
• 10 Mincheff TV. Metastatic spread to a percutaneous gastrostomy site from head and neck cancer: case report and literature review. JSLS 2005; 9 (04) 466-471
• 11 Preyer S, Thul P. Gastric metastasis of squamous cell carcinoma of the head and neck after percutaneous endoscopic gastrostomy – report of a case. [letter] Endoscopy 1989; 21 (06) 295
• 12 Heinbokel N, König V, Nowak A, Carstens V. [A rare complication of percutaneous endoscopic gastrostomy: metastasis of adenocarcinoma of the stomach in the area of the gastric stoma]. [in German] Z Gastroenterol 1993; 31 (10) 612-613
• 13 Laccourreye O, Chabardes E, Mérite-Drancy A. et al. Implantation metastasis following percutaneous endoscopic gastrostomy. J Laryngol Otol 1993; 107 (10) 946-949
• 14 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
• 15 Lazaridis N, Murino A, Telese A, Koukias N, Despott EJ. A multimodality endoscopic approach for the management of buried bumper syndrome. Endoscopy 2019; 51 (12) E410-E411