Percutaneous endoscopic gastrostomy and jejunostomy: Indications and techniques

Table 1 Indications for percutaneous endoscopic gastrostomy placement

Benign	Malignant	Pediatric
Neurological diseases and psychomotor retardation. Cerebrovascular disease. Motor neuron disease (amyotrophic lateral sclerosis). Multiple sclerosis. Parkinson’s disease. Dementia. Psychomotor retardation. Reduced level of consciousness. Head injury. Intensive care patients. Prolonged coma. Burns. Short bowel syndromes (Crohn’s disease). Facial surgery. Polytrauma. Benign esophageal strictures. Other causes of malnutrition (anorexia)	Cerebral tumor. Cancer with catabolic status. Head and neck cancer. Esophageal cancer. Gastric decompression	Cerebral palsy. Congenital anomaly (e.g., trachea esophageal fistula). Cystic fibrosis. Short bowel syndrome

Table 2 Contraindications to percutaneous endoscopic gastrostomy placement

Relative	Absolute
Peptic ulcer bleeding with high risk of rebleeding. Ascites. Ventriculoperitoneal shunts. Abdominal scars. Large intrathoracic hiatal hernia	Coagulation disorders (INR > 1.5, PTT > 50 s). Platelet count < 50000 mm3. Sign of sepsis. Peritonitis. Peritoneal carcinomatosis. Lack of a safe tract for percutaneous insertion. History of total gastrectomy

INR: International normalized ratio; PTT: Partial thromboplastin time.