In which scenario is PEG/PEJ more relative contraindicated?

Percutaneous Endoscopic Gastrostomy (PEG) or Percutaneous Endoscopic Jejunostomy (PEJ) is a procedure used for feeding patients who cannot consume food orally. While these procedures can be life-saving and enhance the quality of life for patients with feeding difficulties, there are specific situations where they may be more contraindicated.

In patients at risk of tube displacement, the use of PEG or PEJ can be particularly concerning. Having a higher risk of displacement may indicate situational or anatomical factors that can lead to complications, such as infection, misplacement, or disruption of the feeding regimen. This risk makes it critical to assess the suitability of the procedure carefully since dislodgement or displacement of the tube can lead to significant morbidity and may require surgery for replacement or correction.

In contrast, situations such as single organ failure, diffuse gastric cancer, or older adults with no prior surgeries may present their own challenges, but they do not inherently carry the same acute concerns regarding tube displacement as seen in the third scenario. Overall, understanding the risks associated with PEG/PEJ placement helps ensure patient safety and optimize feeding strategies.