内視鏡を用いる工夫によりPTEG（経皮経食道胃管挿入術）における合併症を回避しえた1例

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Introduction: Percutaneous transesophageal gastro-tubing (PTEG) is associated with nosebleed.

Patient: The patient was an 88-year-old man with dysphagia. Since it would be difficult for him to undergo gastrostomy because of his previous history of dysphagia associated with subarachnoid hemorrhage, thoracoabdominal aortic aneurysm and esophageal hiatal hernia, we chose PTEG as the feeding method.

Initially, we inserted a rupture-free balloon catheter (RFB) nasally according to the original PTEG method, but it caused massive nosebleed requiring consultation of an otorhinolaryngologist. On a subsequent day, a Jagwire™ was inserted through a scope channel of the endoscope into the esophagus and then an RFB was perorally inserted along the Jagwire™, thereby preventing the occurrence of nosebleed.

Results and discussion: The lack of requirement of an endoscope is an advantage of the original PTEG method. In this patient, however, aggressive use of the endoscope enabled us to perform PTEG while preventing nosebleed.