G-tube complications - Revision history

Danbot: Add verified PubMed references (PMIDs 40342392)

2026-03-22T10:56:57Z

Add verified PubMed references (PMIDs 40342392)

← Older revision		Revision as of 10:56, 22 March 2026
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	==Background==		==Background==
	[[File:PMC4979342 AMS-6-44-g005.png\|thumb\|Child with percutaneous gastrostomy tube (G-tube).]]		[[File:PMC4979342 AMS-6-44-g005.png\|thumb\|Child with percutaneous gastrostomy tube (G-tube).]]
	*Percutaneous gastrostomy tubes (PEG/G-tubes) are common in patients with impaired swallowing, neurologic disease, or need for chronic enteral access		*Percutaneous gastrostomy tubes (PEG/G-tubes) are common in patients with impaired swallowing, neurologic disease, or need for chronic enteral access<ref>Peters G, Bittman R, Sankhla T. Complications of Gastrostomy Tube Placement. Semin Intervent Radiol. 2025 Feb;42(1):22-30. PMID 40342392</ref>
	*G-tube complications are a frequent ED presentation, especially in pediatric and geriatric patients		*G-tube complications are a frequent ED presentation, especially in pediatric and geriatric patients
	*'''Key EM pearl''': a dislodged G-tube in a mature tract (>4-6 weeks old) must be replaced promptly — the tract can close within hours		*'''Key EM pearl''': a dislodged G-tube in a mature tract (>4-6 weeks old) must be replaced promptly — the tract can close within hours

Danbot: Expanded with concise EM-focused content: dislodged tube management, mature vs immature tract distinction, complication management

2026-03-21T00:33:05Z

Expanded with concise EM-focused content: dislodged tube management, mature vs immature tract distinction, complication management

← Older revision		Revision as of 00:33, 21 March 2026
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	~~<languages~~/>		==Background==
	~~<translate~~>		[[File:PMC4979342 AMS-6-44-g005.png\|thumb\|Child with percutaneous gastrostomy tube (G-tube).]]
			*Percutaneous gastrostomy tubes (PEG/G-tubes) are common in patients with impaired swallowing, neurologic disease, or need for chronic enteral access
			*G-tube complications are a frequent ED presentation, especially in pediatric and geriatric patients
			*'''Key EM pearl''': a dislodged G-tube in a mature tract (>4-6 weeks old) must be replaced promptly — the tract can close within hours

	==~~Background~~==		==Complications==
			{{DDX G-tube}}

			===Dislodged/Displaced Tube===
			*Most common ED presentation
			*'''Mature tract (>4-6 weeks)''': replace with same-size tube or Foley catheter as bridge to prevent tract closure
			**Lubricate and gently advance; confirm placement with aspiration of gastric contents or water-soluble contrast study
			**Do NOT use air insufflation — risk of misplacement
			*'''Immature tract (<4 weeks)''': higher risk of peritoneal misplacement → GI/surgery consultation; do NOT blindly replace
			*Verify intragastric position: aspirate gastric contents (pH <4), instill water-soluble contrast and obtain abdominal X-ray

			===Clogged Tube===
			*Try warm water flush with 30-60 mL syringe (gentle pressure)
			*Carbonated water, pancreatic enzyme solution, or meat tenderizer can help
			*Avoid using wire/stylet to unclog (perforation risk)
			*May need tube replacement if unable to clear

			===Peristomal Infection===
			*Erythema, warmth, purulent drainage at stoma site
			*Mild: topical wound care, oral antibiotics (amoxicillin-clavulanate or cephalexin)
			*Severe/cellulitis: IV antibiotics, assess for abscess (may need CT)
			*Consider fungal infection (candida) — treat with topical antifungal

			===Buried Bumper Syndrome===
			*Internal bumper migrates into gastric/abdominal wall
			*Presents with increasing resistance to feeds, pain, leaking
			*Requires endoscopic or surgical removal — consult GI/surgery

	~~[[File:PMC4979342 AMS-6-44-g005.png\|thumb\|Child with percutaneous gastrostomy tube (G-tube)]]~~		===Leaking Around Tube===
	*~~The percutaneous gastrostomy~~ tube ~~(PEG) is commonly indicated in:~~		*Common — often due to tube being too small, excessive traction, or granulation tissue
	**patients with impaired ability to tolerate PO for caloric supplementation, ~~hydration~~, ~~frequent enteral medication dosing~~		*Reduce traction, ensure proper tube size
	**oropharyngeal or ~~esophageal obstruction~~		*Silver nitrate for granulation tissue (if trained)
	**major facial trauma
	**passive gastric decompression
	**mechanical apposition of the stomach to the abdominal wall to prevent hiatal herniation.

			===Peritonitis===
			*Rare but serious — tube tip in peritoneal cavity
			*Fever, diffuse abdominal pain, peritoneal signs
			*CT abdomen, IV antibiotics, surgical consultation

	==~~Categories~~==		==Evaluation==
			*Abdominal exam: peritoneal signs, peristomal skin assessment
			*Confirm tube position if replaced: aspirate for gastric contents, water-soluble contrast study (do NOT use barium — peritonitis risk if extravasation)
			*Abdominal X-ray or CT if concern for misplacement or peritonitis

	</~~translate>~~		==Management Summary==
	~~{{DDX G-tube}}~~		*Dislodged + mature tract → replace, verify position, discharge with follow-up
	~~<translate>~~		*Dislodged + immature tract → consult GI/surgery, do not blindly replace
			*Clogged → flush; replace if unable to clear
			*Infection → antibiotics (PO or IV based on severity)
			*Peritonitis → IV antibiotics, surgery consultation, admit

			==Disposition==
			*Discharge: successful tube replacement confirmed in position, mild peristomal infection, clogged tube resolved
			*Admit: peritonitis, failed replacement, immature tract dislodgement, systemic infection

	==See Also==		==See Also==
			*[[Ostomy complications]]

	==References==		==References==
			<references/>

	[[Category:GI]] [[~~category~~:Surgery]] [[Category:Symptoms]]		[[Category:GI]]
	~~</translate>~~		[[Category:Surgery]]
			[[Category:Symptoms]]

Ostermayer: Prepared the page for translation

2026-01-04T22:55:23Z

Prepared the page for translation

← Older revision		Revision as of 22:55, 4 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==

	[[File:PMC4979342 AMS-6-44-g005.png\|thumb\|Child with percutaneous gastrostomy tube (G-tube)]]		[[File:PMC4979342 AMS-6-44-g005.png\|thumb\|Child with percutaneous gastrostomy tube (G-tube)]]
	*The percutaneous gastrostomy tube (PEG) is commonly indicated in:		*The percutaneous gastrostomy tube (PEG) is commonly indicated in:
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	**passive gastric decompression		**passive gastric decompression
	**mechanical apposition of the stomach to the abdominal wall to prevent hiatal herniation.		**mechanical apposition of the stomach to the abdominal wall to prevent hiatal herniation.


	==Categories==		==Categories==

			</translate>
	{{DDX G-tube}}		{{DDX G-tube}}
			<translate>


	==See Also==		==See Also==


	==References==		==References==

	[[Category:GI]] [[category:Surgery]] [[Category:Symptoms]]		[[Category:GI]] [[category:Surgery]] [[Category:Symptoms]]
			</translate>

Rossdonaldson1: /* Video */

2024-03-27T22:07:18Z

Video

← Older revision		Revision as of 22:07, 27 March 2024
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	{{DDX G-tube}}		{{DDX G-tube}}

	==~~Video~~==		==See Also==
	*https://youtube.com/RCT2b4VzbAo EM5 Feeding tube replacement
			==References==

	[[Category:GI]] [[category:Surgery]] [[Category:Symptoms]]		[[Category:GI]] [[category:Surgery]] [[Category:Symptoms]]

Rossdonaldson1: /* Video */

2023-04-26T19:54:42Z

Video

← Older revision		Revision as of 19:54, 26 April 2023
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	==Video==		==Video==
	~~{{#widget~~:~~YouTube\|id=~~RCT2b4VzbAo}}		*https://youtube.com/RCT2b4VzbAo EM5 Feeding tube replacement

	[[Category:GI]] [[category:Surgery]] [[Category:Symptoms]]		[[Category:GI]] [[category:Surgery]] [[Category:Symptoms]]

Rossdonaldson1: /* Background */

2019-10-29T17:35:37Z

Background

← Older revision		Revision as of 17:35, 29 October 2019
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	==Background==		==Background==
			[[File:PMC4979342 AMS-6-44-g005.png\|thumb\|Child with percutaneous gastrostomy tube (G-tube)]]
	*The percutaneous gastrostomy tube (PEG) is commonly indicated in:		*The percutaneous gastrostomy tube (PEG) is commonly indicated in:
	**patients with impaired ability to tolerate PO for caloric supplementation, hydration, frequent enteral medication dosing		**patients with impaired ability to tolerate PO for caloric supplementation, hydration, frequent enteral medication dosing

Rossdonaldson1 at 17:14, 29 October 2019

2019-10-29T17:14:12Z

← Older revision		Revision as of 17:14, 29 October 2019
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	~~==Categories==~~
	~~{{DDX G-tube}}~~

	==Background==		==Background==
	*The percutaneous gastrostomy tube (PEG) is commonly indicated in:		*The percutaneous gastrostomy tube (PEG) is commonly indicated in:
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	**passive gastric decompression		**passive gastric decompression
	**mechanical apposition of the stomach to the abdominal wall to prevent hiatal herniation.		**mechanical apposition of the stomach to the abdominal wall to prevent hiatal herniation.

			==Categories==
			{{DDX G-tube}}

	==Video==		==Video==

ClaireLewis at 20:48, 29 September 2019

2019-09-29T20:48:09Z

← Older revision		Revision as of 20:48, 29 September 2019
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	{{#widget:YouTube\|id=RCT2b4VzbAo}}		{{#widget:YouTube\|id=RCT2b4VzbAo}}

	[[Category:GI]]		[[Category:GI]] [[category:Surgery]] [[Category:Symptoms]]

Rossdonaldson1 at 22:52, 24 May 2016

2016-05-24T22:52:49Z

← Older revision		Revision as of 22:52, 24 May 2016
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	**passive gastric decompression		**passive gastric decompression
	**mechanical apposition of the stomach to the abdominal wall to prevent hiatal herniation.		**mechanical apposition of the stomach to the abdominal wall to prevent hiatal herniation.

			==Video==
			{{#widget:YouTube\|id=RCT2b4VzbAo}}

	[[Category:GI]]		[[Category:GI]]

Neil.m.young at 18:54, 31 January 2016

2016-01-31T18:54:49Z

← Older revision		Revision as of 18:54, 31 January 2016
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			==Categories==
	{{DDX G-tube}}		{{DDX G-tube}}

			==Background==
			*The percutaneous gastrostomy tube (PEG) is commonly indicated in:
			**patients with impaired ability to tolerate PO for caloric supplementation, hydration, frequent enteral medication dosing
			**oropharyngeal or esophageal obstruction
			**major facial trauma
			**passive gastric decompression
			**mechanical apposition of the stomach to the abdominal wall to prevent hiatal herniation.

	[[Category:GI]]		[[Category:GI]]