Surgical placement of a feeding tube through the skin of the abdominal wall directly into the stomach has become a routine procedure for a variety of clinical situations. The Percutaneous Gastrostomy can be correctly placed by viewing the inside of the stomach through a gastroscope (Endoscopic, PEG), during Diagnostic UltraSound screening (Radiographic, PRG) or as a formal Surgical procedure.
Minor complications are common, major relatively rare, though PEG and PRG1 may be safer2 than Percutaneous Surgical Gastrostomy. If the transverse colon becomes interposed between skin and stomach, the gastrostomy may traverse it, potentially causing peritonitis and/or a gastro-colic fistula. Arguably3, perforation of the colon during percutaneous gastrostomy is preventable4 and is caused by substandard technique5, until proved otherwise6.
Copyright © Handbook of Legal Medicine