Is "second look" endoscopy necessary after PEG?

E. J. Heinzelmann, B. L. Woods, E. N. Steinberg, R. Vasudeva, Colin Howden

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Although second look endoscopy is commonly performed after PEG, the potential risks of aspiration and infection may outweigh any benefits obtained. AIM: We sought to identify whether second look endoscopy should be performed after PEG. METHODS: Prospective, randomized, controlled trial in 71 consecutive male veterans undergoing EGD with PEG. Patients were randomized to group 1 (second look) or group 2 (no second look). Otherwise, management was identical for both groups including use of antibiotics pre- and post-PEG. Patients were examined daily until day 3 post-PEG for signs and symptoms of aspiration pneumonia, gastrointestinal (GI) hemorrhage, local signs of erythema and purulence, and the presence of active bowel sounds or abdominal rigidity. Examination was by individuals blinded as to which patients had a second look endoscopy. 62 patients were evaluable (group 1, n = 32 ; group 2, n = 30). RESULTS: Patients in groups 1 and 2 had similar findings on post-PEG day 1. On day 2, more patients in group 1 had erythema (6/32 vs. 1/30 ; P<0.05) and purulence (1/32 vs. 0/30 ; NS), and more had evidence of aspiration pneumonia (4/32 vs. 0/30 ; P<0.05) and GI hemorrhage (2/32 vs. 0/30 ; NS). On day 3, more patients in group 1 had erythema (9/32 vs. 2/30 ; P<0.05) and purulence (4/32 vs. 1/30 ; NS). In addition, more patients in group 1 had evidence of aspiration pneumonia (5/32 vs. 0/30 ; P<0.05) and GI hemorrhage (2/32 vs. 0/30 ; NS). Patients in groups 1 and 2 did not differ with respect to the presence of active bowel sounds or the absence of abdominal rigidity at any point during the study. CONCLUSIONS: Second look endoscopy is unnecessary following PEG and may be associated with an increased incidence of complications including aspiration pneumonia and local wound infection.

Original languageEnglish (US)
Number of pages1
JournalGastrointestinal Endoscopy
Volume43
Issue number4
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

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Endoscopy
Aspiration Pneumonia
Gastrointestinal Hemorrhage
Erythema
Veterans
Wound Infection
Signs and Symptoms
Randomized Controlled Trials
Anti-Bacterial Agents
Incidence
Infection

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Is "second look" endoscopy necessary after PEG? / Heinzelmann, E. J.; Woods, B. L.; Steinberg, E. N.; Vasudeva, R.; Howden, Colin.

In: Gastrointestinal Endoscopy, Vol. 43, No. 4, 01.01.1996.

Research output: Contribution to journalArticle

Heinzelmann, E. J. ; Woods, B. L. ; Steinberg, E. N. ; Vasudeva, R. ; Howden, Colin. / Is "second look" endoscopy necessary after PEG?. In: Gastrointestinal Endoscopy. 1996 ; Vol. 43, No. 4.
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