PERCUTANEOUS TRANSESOPHAGEAL GASTROSTOMY TUBE PLACEMENT IN THE SETTING OF PERITONEAL DIALYSIS

Document Type

Conference Proceeding

Publication Date

4-1-2025

Publication Title

Am J Kidney Dis

Abstract

PD). While PD provides advantages including preservation of renal function and lifestyle flexibility, many patients are at increased risk of malnutrition which can lead to increased morbidity and mortality1. Additionally, percutaneous endoscopic gastrostomy (PEG) tube placement can be challenging in this population due to risk of peritonitis and tube leaks. In 1994, Percutaneous Transesophageal Gastrostomy (PTEG) tube placement was developed in Japan as an alternative modality for providing enteral nutrition for patients unable to tolerate PEG tube placement. The procedure involves percutaneous access of the esophagus via the thorax and has shown to be safe and effective, though is not commonly performed in the United States2. We present a case of successful PTEG tube placement in a patient on peritoneal dialysis An 85 year old male with a past medical history of ESRD, prostate cancer, and tongue and laryngeal cancer presented for evaluation of decreased oral intake and cough. The patient had a long history of dysphagia, with intolerance to solid food and productive cough attributed to aspiration for one week prior to admission. The patient had a PD catheter placed 11 days before presentation and hemodialysis was deferred due to difficulties with transportation as an outpatient. He received video fluoroscopy demonstrating 100% aspiration and was not considered a candidate for PEG tube placement due to risk of peritonitis. The patient was treated for aspiration pneumonia with antibiotics and had a PTEG tube placed without any complications. After the procedure, the patient’s complaints resolved, and he was able to receive PD and tube feeding without incident While PTEG tube placement has commonly been used in the setting of gastrointestinal malignancies, patients receiving PD should be considered for PTEG tube placement for treatment of malnutrition. There is anecdotal evidence suggesting this modality is useful in patients on PD3, however data regarding outcomes is limited. To our knowledge, this is the 1st reported case of PTEG tube insertion in a patient on PD in the United States. Additional study of this procedure's outcomes would b

Volume

85

Issue

4

First Page

S173

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