What complication is related to PEG and PEJ procedures?

Fistula formation is a known complication associated with Percutaneous Endoscopic Gastrostomy (PEG) and Percutaneous Endoscopic Jejunostomy (PEJ). In these procedures, a feeding tube is placed directly into the stomach or jejunum through the abdominal wall, which can lead to the abnormal connection between two epithelial surfaces that forms a fistula. This complication can occur if the tube is inadvertently placed into adjacent structures or if there is excessive movement of the tube that disrupts the healing process at the insertion site.

While pneumonia, abdominal pain, and nausea can also occur after PEG or PEJ procedures, they are not directly due to the placement of the feeding tube itself. Pneumonia may develop if aspiration occurs during the initial feeding phase or due to improper tube placement leading to aspiration risk. Abdominal pain is often related to procedural discomfort or reactions to the feeding, and nausea can arise for similar reasons or as a side effect of the feeding regimen. However, fistula formation specifically relates to the failure of the tissue to heal properly or to maintain its integrity around the feeding tube site.