Persistent Ostomy Following Percutaneous Endoscopic Gastrostomy Removal: Treatment Strategies.

Endashaw Omer, Alsiddig Elmahdi, Mohamed Eisa, Robert Martindale

Journal: Current gastroenterology reports 2024;26(2):53-56

PMID: 38194110

Abstract

PURPOSE OF REVIEW

The purpose of this article is to review available literature on management of persistent ostomy following PEG tube removal. We will discuss the incidence of persistent gastrocutaneous fistula (GCF) following PEG tube removal, risk factors for their development, and management strategies that have been proposed and their efficacy.

RECENT FINDINGS

The use of over the scope clips (OTSC) have evolved recently in the management of gastrointestinal bleeding, perforation, and fistula closures. OTSC has become more readily available and proven to be effective and safe. Suturing devices have shown promising results. Persistent gastrocutaneous fistula following PEG removal is a rare yet serious complication that can lead to continuous skin irritation and leakage of gastric contents and acid. There are several postulated risk factors but the most important of these is duration of placement. Management can include medical therapy which has recently been shown to be somewhat effective, endoscopic therapy and surgery as a last resort. Overall, the data on GCFs is limited and further study with larger sample size is needed.

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Address: Virginia Commonwealth University Health Systems, Richmond, VA, USA.; Allegheny Center for Digestive Health, Allegheny Health Network, Pittsburgh, PA, USA.; Department of Surgery, Oregon Health Sciences University, Portland, OR, USA.; Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville School of Medicine, 530 S Jackson St ACB bldg 3rd floor, 40202, Louisville, KY, USA. [email protected].

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