Background: Patients without adequate abdominal-wall transillumination are at a high risk of developing complications after PEG.
Objective: We evaluated the feasibility and utility of EUS to guide PEG in patients lacking abdominal-wall transillumination.
Design: Single-center case series.
Setting: Tertiary-referral center.
Patients: Six patients who lacked adequate abdominal-wall transillumination and 2 patients with a large laparotomy scar deemed to be at high risk of developing complications after PEG.
Interventions: Patients underwent EUS-guided PEG and deployment of a standard enteral feeding tube.
Main outcome measurements: Technical success and complication rates.
Results: PEG was successful under EUS guidance in 5 of 8 patients. Causes of failure included an inadequate EUS window because of a prior Billroth 1 gastrectomy in one and suspected bowel interposition in 2 patients. There were no complications.
Limitations: A small number of patients, uncontrolled study, and short follow-up period.
Conclusions: This technique may facilitate deployment of PEG in patients who lack adequate abdominal-wall transillumination.