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Emergency PEG Reinsertion

If an existing Gastrostomy tube has fallen out, or been accidentally pulled out, the stoma will close quickly, often in the space of a few hours. The appropriate specialist, registrar or CNC should be contacted immediately and they may delegate the reinsertion of the tube. It is important that a tube is re inserted as soon as possible to prevent the stoma closing.

How long has the Gastrostomy been in situ?

If this is less than 6 weeks a mature track may not have formed and the risks of inadvertently placing the replacement tube in the peritoneal cavity are high. A mature track can take many weeks to form in a malnourished patient.

If there is a mature gastrostomy track, reinsertion of a balloon tube can be attempted.

Tube reinsertion

If there has been any difficulty reinserting the tube, particularly in patients who cannot communicate well, its correct position should be checked with a gastrographin study.

Water or a test feed should be instilled into the stomach before the patient leaves the hospital.

Because of problems retaining a urinary catheter in the correct position a urinary catheter is not appropriate for long term use as a Gastrostomy tube.

If a urinary catheter has been used arrangements should be made for this to be changed to a Gastrostomy tube as soon as possible.