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Feeding Tube Complications, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Extubation:

    • Accidental or intentional

    • More common with nasoenteric tubes compared with percutaneous endoscopic gastrostomy (PEG) tubes, gastrostomy tubes (G tubes), or jejunostomy tube...

Diagnosis

Signs and Symptoms

  • Extubation:

    • Tube removed from source

  • Occlusion:

    • Unable to pass liquid through tube

  • Tube migration:

    • Distal displacement of PEG tube

    • Obstruction at or distal to pylorus

    • Dumping synd...

Treatment

Pre-Hospital

If extubation of tube has occurred, transport tube with patient to facilitate easier replacement 

Initial Stabilization/Therapy

  • ABCs

  • IV fluid resuscitation for dehydration/sepsis

Ed Treatment/Procedures

Follow-Up

Disposition

Admission Criteria

  • PEG tube extubation within 1 wk of placement

  • Surgical G tube or J tube extubation within 3 days of placement

  • Significant peristomal wound infection

  • Aspiration pneum...

Pearls and Pitfalls

  • Radiography should be used to confirm placement of all feeding tubes

  • Do not attempt replacement of a newly placed PEG tube, G tube, or J tube in the ED

Additional Reading

  • Metheny  NA, Meert  KL, Clouse  RE. Complications related to feeding tube placement. Curr Opin Gastroenterol.  2007;23:178–182.

  • Niv  E, Fireman  Z, Vaisman  N. Post-pyloric feed...

Codes

ICD9

  • 536.40 Gastrostomy complication, unspecified

  • 536.49 Other gastrostomy complications

  • 996.79 Other complications due to other internal prosthetic device, implant, and graft

  • 536.42 Mechanical comp...

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