Percutaneous transesophageal gastrotubing in a child with severe motor and intellectual disabilities: An effective alternative route of enteral feeding

Percutaneous transesophageal gastrotubing (PTEG) was performed in a 12-year-old boy with severe motor and intellectual disabilities (SMID) whose trunk was severely deformed. He was referred to our pediatric surgical service for tracheostomy and percutaneous endoscopic gastrostomy (PEG) due to respiratory failure and difficulty in oral intake. Considering that the patient could not maintain a supine position, a standard gastrostomy procedure, either open or endoscopic, could not be performed. Moreover, postoperative care for gastrostomy would be challenging. Therefore, PTEG through the stretched anterior neck was indicated. PTEG involves creating an echo-guided percutaneous esophageal puncture under fluoroscopy to introduce a feeding tube from the esophagus into the stomach. PTEG has not been used in pediatric patients yet however, the procedure seems to be an effective alternative route of enteral feeding in children with SMID who cannot undergo PEG, as demonstrated in the present report.