Contraindications - Nutricia FLOCARE DirectPEG Gebrauchsanweisung

CONTRAINDICATIONS

Absolute contraindications
• Transillumination is not possible
• Coagulopathy
• Severely impaired general wound healing
• Sepsis
• Peritonitis
• Acute pancreatitis
• Obstructions in the lower gastrointestinal tract
• Tumour infiltration at the puncture site
• Visible liver tumour
POSSIBLE COMPLICATIONS
• Injuries to the posterior gastric wall caused by the trocar during placement rarely occur and
can almost be ruled out by careful handling. Furthermore, in children and patients with reduced
abdominal fat, special care should be taken considered to ensure that the trocar is not introdu-
ced with excessive external pressure.
• In rare cases, placement of a PEG can cause secondary peritonitis due to gastric puncture.
• Due to air insufflation and simultaneous puncture of the stomach, as with any PEG system,
there is a risk of air entering the peritoneum. This occurs in approx. 50 % of PEG placements
and, in most cases, does not have any clinical relevance.
• In rare cases, inadequate or excessive care of the stoma or the surrounding skin area can cause
cellulitis or eczema.
• In rare cases, excessive mobilisation of the tube or changes in the position (several times a
day) of the tube can cause the formation of hypergranulation tissue and should, therefore, be
avoided.
• The risk of buried bumper syndrome is minimised due to the tyre-shaped balloon design of the
tube and the therefore enlarged contact area, however in rare cases, inadequate mobilisation of
the tube may result in buried bumper syndrome.
• A PEG that is placed too tight can cause necrosis (necrosis of the skin and/or stoma) due to
the reduced blood flow to the tissue between the external disc and the balloon located in the
stomach.
• In rare cases, insufficient or incorrect flushing of the tube can result in the tube becoming
blocked. This can result in the patient being insufficiently supplied with food and/or liquid or
may mean that another intervention is required to change the tube.
Relative contraindications
(to be decided on a case-by-case basis
after clearly weighing the benefits)
• Immunosuppression
• Ascites
• Peritoneal carcinomatosis
• Peritoneal dialysis (PD)
• Ventriculoperitoneal shunt
• Severe psychosis
• Anorexia nervosa
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