PERCUTANEOUS ENDOSCOPIC GASTROSTOMY - EXPERIENCES IN CHILDREN

Background: Since percutaneous endoscopic gastrostomy in children is simple and safe it was rapidly accepted for clinical use in the years 1989 to 1992. Methods: We want to describe the complications and advantages of this feeding method in 10 of our patients aged 1 1/12 to 24 11/12 years. From 1989 to 1992 gastrostomy tubes were placed in 10 patients. Three patients suffered from cystic fibrosis, three from neurologic diseases, one from Ewing sarcoma, one from graft versus host disease, one from AIDS, and one from end stage renal disease maintained on peritoneal dialysis. Results: We observed no perioperative complications. Catheter tract infections occurred in 4 patients and were successfully treated nonoperatively. Two neurologically impaired children developed reflux oesophagitis. On follow up either an isocaloric enteral nutrition was possible or in 6 patients, the weight improved. Two patients died shortly after PEG placement not due to the procedure. We removed one catheder because of leakage at peritoneal dialysis. One child used tube feeding inconsequently and weight gain was poor. Conclusions: Even in severe chronic disease sufficient enteral feeding was possible after percutaneous endoscopic gastrostomy. The procedure was simple and safe. The high incidence of reflux oesophagitis in neurologically impaired children warrents careful follow up.