Percutaneous endoscopic gastrostomy (PEG) has become the method of choice for mid-to long-term enteral feeding. The majority of complications that occur are minor, but the rare major complications may be life threatening. Some complications occur soon after tube placement, others develop later, when the gastrostomy tract has matured. Older patients with comorbidities and infections appear to be at a greater risk of developing complications. Apart from being aware of indications and contraindications, proper technique of PEG placement, including correct positioning of the external fixation device, and daily tube care are important preventive measures. Adequate management of anticoagulation and antithrombotic agents is important to prevent bleeding, and administration of broad spectrum antibiotics prior to the procedure helps prevent infectious complications. Early recognition of complications enables prompt diagnosis and effective therapy.

• Klíčová slova
• Bleeding, Complication, Fistula, Percutaneous endoscopic gastrostomy, Wound infection,
• MeSH
• enterální výživa MeSH
• gastrointestinální intubace škodlivé účinky   metody   MeSH
• gastroskopie škodlivé účinky   MeSH
• gastrostomie škodlivé účinky   metody   MeSH
• lidé MeSH
• pooperační komplikace etiologie   prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

UNLABELLED: Amyloidosis is a rare disease characterized by forming pathological protein deposits - amyloid - in many organs and tissues. This decreases their functionality. The aim of this small study was to determine, whether the radiological picture of the small intestine involvement in amyloidosis is in some sense specific as sometimes described in literature giving rise to high suspicion for the disease in symptomatic patients. MATERIAL AND METHODS: The prospective study comprising seven patients hospitalized in surgical department is presented together with a survey on the disease, its appearance in radiological imaging. All patients underwent abdominal ultrasound (ATL 5000 HDI, 7-12MHz linear probe, no contrast enhancement, supine position), abdominal CT (Somatom Plus, Siemens, single detector, conventional abdominal CT protocol) and enteroclysis (Micropaque suspension 300ml, application rate of 75ml/min, dilution with HP-7000 being 1:1 and HP-7000 solution 2000ml, application rate of 120ml/min.). RESULTS: The amyloid deposits in the small intestine could be visualized in five of seven patients with the disease. Enteroclysis revealed a diffuse slowed down intestinal motility with an obstruction-like picture in all of our seven patients. The intestinal secretion was normal, plicae were getting polyp-like shape in five of them forming so called "thumb printing" picture. CT showed thickening of the intestinal wall due to deposits with poor blood supply and contrast retention in five of seven patients. Ultrasound visualized thickened, hypoechoic nodular plicae and slowed down motility in these five patients. The most striking finding was the pathological deposits in the intestinal wall were highly hypo-vascular. However, this picture is very similar to that of ischemic enteritis. All seven patients had proven amyloid deposits from bioptic specimens. CONCLUSION: The diagnosis of amyloidosis must be supported by bioptic examination as it has no pathognomic radiological picture. Nevertheless, it allows usually to rise a high suspicion for this and sometimes even guess the type of the pathological protein involved. This can start a search for the primary reason of possible amyloidosis and thus perhaps spear the patients quality of life.

• MeSH
• amyloidóza komplikace   diagnóza   MeSH
• dyspepsie etiologie   MeSH
• gastrointestinální intubace metody   MeSH
• kontrastní látky aplikace a dávkování   MeSH
• lidé MeSH
• nemoci střev diagnóza   MeSH
• počítačová rentgenová tomografie MeSH
• prospektivní studie MeSH
• senzitivita a specificita MeSH
• síran barnatý MeSH
• tenké střevo diagnostické zobrazování   MeSH
• ultrasonografie MeSH
• vylepšení obrazu metody   MeSH
• vzácné nemoci MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• Názvy látek
• kontrastní látky MeSH
• síran barnatý MeSH