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September 9, 1992

Removal of Gastrostomy Tubes-Reply

Author Affiliations

University of Southern California Downey

JAMA. 1992;268(10):1270. doi:10.1001/jama.1992.03490100064029

In Reply.  —Mr Campbell and his colleagues report a case where a fatal outcome occurred in a patient with anoxic brain injury in whom the gastrostomy tube was cut, allowed to pass intestinally, and resulted in intestinal perforation and abscess formation. They suggest that PEG tubes that cannot be removed by external traction be endoscopically removed, especially in cases where abdominal surgery was previously performed.Although the majority (98%) of evaluable patients in our study eliminated the internal component of the PEG tube intestinally, in one patient the internal bumper lodged at the pylorus and required endoscopic removal. A number of patients in our study had had abdominal surgery at the time the initial PEG tubes were placed and did not have problems with elimination when their PEG tubes were removed nonendoscopically. Thus, an occasional patient may require an alternative method for removal of the internal PEG component and prior