Percutaneous endoscopic gastrostomy (PEG) is a common procedure for placing a feeding tube in the stomach to provide fluids and nutrition to patients who have difficulty in swallowing or in taking enough noutrishment through the mouth. Thought the procedure is simple and easy, PEG is not without its risks. The reported complication ratio is not low-, -between 5.7% and 33.3%. This is probably because the patients are lacking in reserves of physical faculties.The present study was conducted to work out measures to reduc the incidence of PEG complications by reviewing the complications cases treated in our hospital.From March 1997 to December 2005, we performed PEG on 110 patients, of which 11 patients (9.6%) had complications. In some cases, we inadvertently perforated the colon. From our experience, we have learned that it is not safe to perform PEG with the aid of radiography alone on cases in which the intervention of the transverse colon between stomach and abdominal wall was suspected by CT scan, and concluded PEG should be done using gastrography of the transverse colon, to guide the placement of a feeding tube in the stomach. In view of the systemic condition of the patients, we thought it necessary to take safety measures by all possible means.
Percutaneous endoscopic gastrostomy ; Complications Specific to Antepartum or Postpartum ; Stomach ; Management ; Prevention

Enteral feeding is generally accepted in patients who cannot take nutrients orally. Percutaneous endoscopic gastrostomy (PEG) is a major enteral means for the introduction of nutritional solutions. However, jejunal feeding is sometimes employed instead of gastric feeding in cases of post-gastrectomy or repeated aspiration after PEG. The digestion and absorption of nutrients in trans-jejunal feeding might be different from those in trans-gastric feeding. In the present study, we measured the serum concentations of micronutrients and vitamins in the cases of direct percutaneous endoscopic jejunostomy (D-PEJ), compared to those of PEG. The enteral feeding has been continued for more than six months in all the cases. Serum copper and zinc concentration were significantly decreased in the D-PEJ group, whereas no significant difference in the concentrations of iron, selenium, vitamins A, B12 and E was ovserved between the two groups. Anemia and neutropenia were frequently observed in many patients with D-PEJ. These conditions were associated with copper deficiency. Much attention should be paid to copper and zinc deficiency in long-term trans-jejunal feeding.
Upper case dee ; Percutaneous endoscopic jejunostomy [PEJ] ; Percutaneous endoscopic gastrostomy ; Serum ; Feeding