PEJ Special Cases and Complications during Tube Placement

Fig. 4.35 Placement of a PEJ

a The puncture needle is passed into a loop of jejunum

Fig. 4.35 Placement of a PEJ

a The puncture needle is passed into a loop of jejunum

b The guide suture is threaded into the jejunum and grasped

Pej Tube Insertion Complications

c View of the bumper on the wall of the jejunum

Fig. 4.36 Tube placed in an interposed colon segment

Fig. 4.37 Tube placed in the duodenum of a patient with a Billroth I gastroduodenostomy

Fig. 4.38 Complications of PEG placement a Injury to the opposite stomach wall due to insufficient air insufflation

Fig. 4.38 Complications of PEG placement a Injury to the opposite stomach wall due to insufficient air insufflation b Bleeding in a patient with a coagulation defect

Pej Tube Placement

c Perforation, with free air below the diaphragm

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