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Nutrition clinique et métabolisme
Volume 14, n° 2
pages 153-156 (juin 2000)
Doi : S0985-0562(00)80076-X
Complications tardives de la gastrostomie percutanée endoscopique (GPE)
Late complications of percutaneous endoscopic gastrostomy
 

Philippe Beau
 Unité fonctionnelle de gastro-entérologie et nutrition artificielle, CHU Poitiers, BP 577, 88021 Poitiers, France 

Résumé

Les complications tardives de la gastrostomie percutanée endoscopique (GPE) les plus fréquentes sont celles survenant autour de l'orifice de la sonde (fuites, suppuration) et les incidents matériels (obstruction, migration), en général bénins. Plus rarement, ont été décrites des complications plus sévères : fistule gastrocolique, ulcérations gastriques parfois compliquées de péritonite ou d'impaction de collerette dans la paroi abdominale, occlusion intestinale et métastases cutanées à l'orifice de sortie de la GPE. Les pneumopathies de déglutition sont les complications les plus sévères de la nutrition entérale par GPE : elles surviennent préférentiellement chez les malades ayant des troubles de la déglutition d'origine neurologique et sont la première cause de mortalité liée à cette technique chez ce type de malades. La GPE, comparée à la sonde nasogastrique, ne semble pas réduire le risque de pneumopathie ni de reflux gastro-œsophagien.

The full text of this article is available in PDF format.
Summary

The most frequent and usually benign late complications following percutaneous endoscopic gastrostomy (PEG) are those occurring around the tube insertion site (leakage, purulent secretions) and deterioration of the gastrostomy tube. More severe complications are unusual such as colo-cutaneous fistula, gastric ulcerations which may be complicated by peritonitis or by the buried bumper syndrome, tube migration into the small bowel or cutaneous metastasis to the PEG exit site. Aspiration pneumonia is one of the most serious complication of PEG and is associated with a high mortality; this complication is more frequent in nursing home patients receiving enteral nutrition for neurologic disorders. Compared to the nasogastric tube, PEG does not seem to reduce the risk of aspiration pneumonia and of gastroesophageal reflux in these patients.

The full text of this article is available in PDF format.

Keywords : complications, gastrostomie percutanée endoscopique, pneumopathie de déglutition

Keywords : aspiration pneumonia, complications, percutaneous endoscopic gastrostomy




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