Percutaneous Access for Enteral Nutrition

Enteral feeding is the preferred method of feeding in the presence of a functional gastrointestinal tract. Percutaneous enteral feeding tubes are indicated in patients requiring long-term (>4-6 weeks) enteral access. Percutaneous gastrostomy, gastrojejunostomy, and direct jejunostomy placement are safe and effective by either endoscopic or radiologic means. Both endoscopic and radiologic methods are preferred over surgical placement due to decreased cost, complications, and morbidity. In most situations, either can be performed depending on local expertise and availability. In certain clinical situations, endoscopic or radiologic approaches may be preferred. The indications, techniques, and relative advantages/disadvantages of endoscopic and radiologic percutaneous access for enteral nutrition are reviewed.