When do I have to put a stomach tube through the abdominal wall?
There are several reasons why a stomach tube should be placed through the abdominal wall. The most common reason for the insertion of a PEG probe is that it is not possible to insert another stomach tube. This occurs, among other things, in patients with mechanical obstructions of the upper food ducts such as the mouth and throat and the esophagus.
Furthermore, a PEG-probe is used if an operation is pending that affects this area. This minimizes the postoperative stress. This is for example the case after an operation in the area of the jaw.
Burns can also lead to this. In tumor patients with a tumor in the upper food ducts, it is possible that the food ducts are free. In this case, however, a PEG probe is preferred, as there is no risk of tumor cells being carried over when the probe is inserted.
If there is a risk of stomach contents entering the airways through a stomach tube, a PEG probe is also used. The risk of aspiration is lower. Furthermore, a PEG probe can be advanced into the small intestine.
Thus, it can be used in case of a closure of the lower stomach opening. Furthermore, a long service life is an indication for a PEG probe. Compared to conventional stomach probes, it can be used for a very long time. It is particularly popular in cases of protracted illness or old age with associated malnutrition.
Complications/risks of a gastric tube
The installation and use of a gastric tube offers some risks besides the advantages. The most common are injuries to the mucous membrane of the mouth, throat or esophagus. This is associated with pain and can lead to bleeding.
These are usually not serious.However, a not insignificant amount of blood can be lost if blood coagulation is disturbed. Sometimes a stomach tube is not positioned correctly. This can either lead to a reduced outflow of stomach contents (e.g. during an operation) or lead food, fluid and medication into the trachea.
Therefore, the position should always be checked. Prolonged use can also lead to ulcers and inflammation of the mucous membrane due to excessive pressure. With PEG probes there is also the risk that the entry point on the skin becomes inflamed.
This site may continue to leak and thus cause further problems. Furthermore, the probe can grow into the stomach mucosa and cause an inflammatory reaction. The most common complication is a blockage of the tube.
Therefore, the tube should be rinsed after use. The correct position of the stomach tube can be checked in various ways. The easiest way is to listen in the area of the stomach.
To do this, air is forced through the tube with a syringe. When the stethoscope is correctly positioned, a bubbling sound should be heard. Liquid can also be sucked through the probe.
The pH value of this secretion can be determined with the help of test strips. If it is acidic, gastric juice is present and the probe is correctly positioned. As a last measure, the correct position can be checked by an X-ray. This procedure is only used when all other methods have not provided a reliable result, as it is very time-consuming and stressful.
