Trans-nasal PEG: An alternative approach to conventional PEG in patients with restricted mouth opening

Enteral nutrition is crucial and prognostically significant in patients with advanced malignancies. However, in many such patients, limited mouth opening renders conventional percutaneous endoscopic gastrostomy (PEG) tube placement impossible. Available options include a long-term indwelling naso-ga...

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Main Authors: Akash Goel, Pankaj Singh, Muzaffar Rashid Shawl, Vikas Singla
Format: Article
Language:English
Published: Society of Gastrointestinal Intervention 2025-07-01
Series:International Journal of Gastrointestinal Intervention
Subjects:
Online Access:https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii240069
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author Akash Goel
Pankaj Singh
Muzaffar Rashid Shawl
Vikas Singla
author_facet Akash Goel
Pankaj Singh
Muzaffar Rashid Shawl
Vikas Singla
author_sort Akash Goel
collection DOAJ
description Enteral nutrition is crucial and prognostically significant in patients with advanced malignancies. However, in many such patients, limited mouth opening renders conventional percutaneous endoscopic gastrostomy (PEG) tube placement impossible. Available options include a long-term indwelling naso-gastric tube or a surgical feeding jejunostomy. Long-term naso-gastric tube placement is associated with its own complications, and surgical feeding jejunostomy typically requires general anaesthesia, which is challenging in these debilitated patients. We present a trans-nasal PEG tube insertion technique that can be performed under local anaesthesia or mild sedation to ensure adequate enteral nutrition. The intricate steps of this procedure are detailed to raise awareness among endoscopists.
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institution Kabale University
issn 2636-0004
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publishDate 2025-07-01
publisher Society of Gastrointestinal Intervention
record_format Article
series International Journal of Gastrointestinal Intervention
spelling doaj-art-fad5d162ba0b49c3bb2c3f42a7d143fa2025-08-20T03:51:43ZengSociety of Gastrointestinal InterventionInternational Journal of Gastrointestinal Intervention2636-00042025-07-0114313113210.18528/ijgii240069ijgii240069Trans-nasal PEG: An alternative approach to conventional PEG in patients with restricted mouth openingAkash Goel0Pankaj Singh1Muzaffar Rashid Shawl2Vikas Singla3Department of Gastroenterology, Hepatology and Endoscopy, Max Superspeciality Hospital, New Delhi, IndiaDepartment of Gastroenterology, Hepatology and Endoscopy, Max Superspeciality Hospital, New Delhi, IndiaDepartment of Gastroenterology, Hepatology and Endoscopy, Max Superspeciality Hospital, New Delhi, IndiaDepartment of Gastroenterology, Hepatology and Endoscopy, Max Superspeciality Hospital, New Delhi, IndiaEnteral nutrition is crucial and prognostically significant in patients with advanced malignancies. However, in many such patients, limited mouth opening renders conventional percutaneous endoscopic gastrostomy (PEG) tube placement impossible. Available options include a long-term indwelling naso-gastric tube or a surgical feeding jejunostomy. Long-term naso-gastric tube placement is associated with its own complications, and surgical feeding jejunostomy typically requires general anaesthesia, which is challenging in these debilitated patients. We present a trans-nasal PEG tube insertion technique that can be performed under local anaesthesia or mild sedation to ensure adequate enteral nutrition. The intricate steps of this procedure are detailed to raise awareness among endoscopists.https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii240069enteralgastrostomyneoplasms
spellingShingle Akash Goel
Pankaj Singh
Muzaffar Rashid Shawl
Vikas Singla
Trans-nasal PEG: An alternative approach to conventional PEG in patients with restricted mouth opening
International Journal of Gastrointestinal Intervention
enteral
gastrostomy
neoplasms
title Trans-nasal PEG: An alternative approach to conventional PEG in patients with restricted mouth opening
title_full Trans-nasal PEG: An alternative approach to conventional PEG in patients with restricted mouth opening
title_fullStr Trans-nasal PEG: An alternative approach to conventional PEG in patients with restricted mouth opening
title_full_unstemmed Trans-nasal PEG: An alternative approach to conventional PEG in patients with restricted mouth opening
title_short Trans-nasal PEG: An alternative approach to conventional PEG in patients with restricted mouth opening
title_sort trans nasal peg an alternative approach to conventional peg in patients with restricted mouth opening
topic enteral
gastrostomy
neoplasms
url https://www.ijgii.org/journal/view.html?doi=10.18528/ijgii240069
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AT pankajsingh transnasalpeganalternativeapproachtoconventionalpeginpatientswithrestrictedmouthopening
AT muzaffarrashidshawl transnasalpeganalternativeapproachtoconventionalpeginpatientswithrestrictedmouthopening
AT vikassingla transnasalpeganalternativeapproachtoconventionalpeginpatientswithrestrictedmouthopening