Percutaneous Endoscopic Gastrostomy Insertion In Children

What you should know

Percutaneous endoscopic gastrostomy (PEG) insertion is a procedure to place a soft, plastic feeding tube into your child's stomach. Your child may need a PEG tube if he cannot get enough nutrition by eating his food. Liquid food can be given through the tube to give your child's body the nutrition it needs. The tube may also be used to remove air and fluid from your child's stomach.


Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Risks

  • The endoscopy may cause damage or bleeding in your child's esophagus, stomach, or abdomen. During or after the procedure, liquid from your child's stomach may get into his lungs and cause an infection. Your child's stoma and skin around it may be bruised and painful. Sores may form in the skin around his stoma, and tissue may grow over the PEG tube.

  • The end of the PEG tube in your child's stomach may move out of place. The PEG tube may become blocked and it may crack, break, or leak. Your child's stomach may not empty into his intestines correctly. A fistula (abnormal tissue opening) may form between your child's skin and stomach or intestines. The stoma may become infected. The infection may spread to other areas of your child's body and become life-threatening.

Getting Ready

The week before your child's procedure:

  • Write down the correct date, time, and location of your child's procedure.

  • When you take your child to see his caregiver, bring a list of his medicines or the medicine bottles. Tell caregivers if your child uses herbs, food supplements, or over-the-counter medicine. If your child is allergic to any medicine, tell his caregiver.

  • Ask your child's healthcare provider if your child needs to stop using certain medicines before his procedure.

  • Your child may need blood tests before his procedure. Talk to your child's healthcare provider about these or other tests he may need. Write down the date, time, and location for each test.

  • Ask about supplies your child may need to care for his PEG tube at home.

The night before your child's procedure:

Ask caregivers about directions for eating and drinking.

The day of your child's procedure:

  • Ask your child's healthcare provider before you give your child any medicine on the day of his procedure. Bring a list of all the medicines your child takes, or his pill bottles, with you to the hospital.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery on your child. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Healthcare providers may put an IV tube into your child's vein. Your child may be given liquids and medicine through the IV.

  • Local anesthesia is a shot of medicine put into your child's abdomen. It is used to numb the area and dull the pain. He may still feel pressure or pushing during the procedure. He will also be given medicine in his IV to keep him calm and relaxed.

Treatment

What will happen:

  • Your child's surgeon will insert the endoscope through your child's mouth, down his esophagus, and into his stomach. The light on the end of the endoscope may be seen through your child's abdomen. The light will help the surgeon find the best place to insert the PEG tube. He may inject air into your child's stomach so he can see clearly.

  • The surgeon will make a small incision in your child's abdomen and insert a catheter with a wire through the opening and into his stomach. The wire will be guided up through the endoscope and into your child's mouth. The PEG tube will be attached to the wire and pulled down into your child's stomach. The surgeon will bring one end of the PEG tube out through the opening in your child's abdomen. The other end of the PEG will stay in your child's stomach and will be held in place with a piece of plastic or small inflated balloon. This will prevent it from coming out through the opening in his abdomen (stoma).

  • Once your child's surgeon is sure the PEG tube is in the right place, the endoscope and wire will be removed. If his surgeon cannot use an endoscope, a PEG tube will be directly inserted into your child's stomach through the incision on his abdomen. The surgeon will use an ultrasound to find the right place to put the PEG tube in your child's stomach.

After your child's procedure:

Your child will be taken to a room to rest until he is fully awake. He will be monitored closely for any problems. Do not let your child get out of bed until healthcare providers say it is okay. He will then be taken to his room. Healthcare providers will show you how to care for your child's stoma and feed him through his PEG tube.

Contact a caregiver if

  • Your child cannot make it to his procedure.

  • Your child has a fever.

  • Your child's symptoms, such as weight loss, nausea, or vomiting, get worse.

  • You have questions or concerns about your child's procedure.

Seek Care Immediately if

  • Your child has new trouble breathing.

  • Your child has severe abdominal pain.

  • Your child seems weaker than usual, and is sleeping more.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Percutaneous Endoscopic Gastrostomy Insertion In Children (Precare)

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