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Table 1 Complications of PEG

From: Mediastinitis complicating a percutaneous endoscopic gastrostomy: a case report

I. Due to the endoscopy procedure
  - Laryngospasm [4], airway obstruction
  - aspiration and pneumonia (4)
  - respiratory depression or apnea [5]
  - desaturation [5] or respiratory distress and acute respiratory failure
  - hypertension [5]
  - fracture of the alveolar ridge while attempting to open the mouth [5]
II. Due to the PEG and the gastrostomy tube
  - perforation/laceration of the oesophagus or the stomach [47]
  - transhepatic insertion of the tube [3]
  - pneumoperitoneum [8]
  - colonic perforation [7]
  - subcutaneous emphysema [9]
  - retroperitoneal hemorrhage [10]
  - aortic perforation [11]
  - erosion of the gastric mucosa and bleeding [4, 5, 9]
  - hematoma or infection of the abdominal wall [4, 7]
  - gastrocolic fistula [12]
  - colocutaneous fistula [13]
  - hypertrophic granulation tissue at the gastrostomy exit [5]
  - burried bumper syndrome [14]
  - malpositioning of the tube or leakage
      • to the subcutaneous tissues → cellulitis, myositis, necrotinzing fasciitis [15], subcutaneous abscess [14].
      • to the peritoneal cavity → peritonitis [5, 9, 12], intraabdominal abscess [9], sepsis[12].
  - migration of the tip of the gastrostomy tube
      • to oesophagus (oesophagitis)
      • to pylorus (obstruction or perforation of the duodenum) [16]
  - migration of the whole PEG tube up to the terminal ileum [17]
  - peristomal hernia or stomal prolapse
  - accidental pulling out or cutting off the tube close to the skin during home care [5]
  - erosion of the tube through the gastric wall
  - obstruction of the tube lumen [6]
  - hub detachment [18] or damage
  - later symptomatic gastroesophageal reflux [7]
  - Ileus [4, 6]
III. Due to the mode of feeding
  - Diarrhoea [6, 16]
  - nausea
  - vomiting
  - Dumping syndrome
  - Ogilvie's syndrome [4]
  - Aspiration pneumonia [19]
  - Constipation and meteorism