Complications after Percutaneous Endoscopic Gastrostomy (PEG) in Paediatric Patients

Background and Aim: Percutaneous Endoscopic Gastrostomy (PEG) provides for enteral nutrition in children with feeding problems. PEG, however, is not without complications. The present study has the aim to identify the incidence of major and minor complications after PEG placement. Methods: All patients receiving a PEG in the period 2008-2011 were reviewed. In a 4 years period we positioned 41 PEG in 41 patients. Their age range was variable between 1 and 16 years. Results: Nine of the 41 patients (21.9 %) developed complications. In 2 cases (4.9%) there were major complications. In one case of gastro-colic fistula a redo surgery was performed that consisted in the fistula closure and a redo gastrostomy. This patient moved a legal action against the hospital. In the second case the child developed a pneumoperitoneum without peritonitis for a wrong position of the tube and also this patient was re-operated to well position the tube and to fix the stomach to the skin. In 7 cases (17 %) there were 7 minor complications: 3 cutaneous orifice enlargement with skin inflammation, 2 granulomas and 2 PEG’s breakdown. Conclusion: PEG placement is generally considered a minor and safe procedure. However, the incidence of complications after PEG placement, according with the literature reports, is variable between 10 and 20 %. We report about 5 % of major complications that required a redo surgery. It is important to write in the informed consent that complications after PEG placement are possible and sometimes a redo surgery is required.