gastrostomi

A gastrostomy is a procedure that creates an opening from the abdominal wall into the stomach to provide access for long-term enteral nutrition or, less commonly, gastric decompression. A tube is passed through the abdominal wall into the stomach, and is referred to as a gastrostomy tube (G-tube) or a percutaneous endoscopic gastrostomy (PEG) tube when placed with endoscopic guidance.

Indications include chronic or severe swallowing disorders and conditions that put patients at risk of aspiration, such as neurological diseases (for example, stroke, cerebral palsy, amyotrophic lateral sclerosis), advanced dementia, head and neck cancer, and other conditions that require long-term nutritional support or medication administration. Gastrostomy tubes offer a more durable solution for ongoing feeding than short-term approaches.

Several techniques are used. PEG is the most common method in which an endoscope guides placement. Radiologically inserted gastrostomy (RIG) uses imaging guidance. Surgical gastrostomy can be open or laparoscopic, and may be chosen when endoscopy or radiology is not feasible. In all cases, the tube is secured at the skin and connected to a feeding or medication regimen, with the goal of delivering nutrition directly to the stomach.

Care and potential complications are important considerations. Tube care includes regular cleaning, skin monitoring, and flushing to prevent blockage. Complications can include infection at the stoma, leakage, tube dislodgement or blockage, and rarely buried bumper syndrome or fistula formation. Alternatives include nasogastric feeding or parenteral nutrition when the GI tract is not usable.