Complications occur in 6-10% of patients, most being minor. The most common complication is infection. Prophylactic antibiotics should be given all PEG tube insertions to help prevent this problem. Migration of tube into the peritoneal cavity also occurs. This leads to necrosis of the abdominal wall.To avoid misplacement the position should always be checked endoscopically. Necrosis of the wall can also lead to spillage of feeds and gastric contents into the peritoneum with subsequent peritonitis. If the colon is punctured at the time of PEG insertion this can lead to the migration of the tube into the colon or gastro-colic fistula. Both present with severe diarrhoea following feeding usually one to two weeks after tube insertion. This mandates tube removal. Pneumoperitoneum is another common complication.

There are few contraindications to PEG placement. Massive ascites is an absolute contraindication. Previous abdominal surgery is a relative contraindication. If there are some difficulty but PEG tube insertion is the only option then the tube can occasionally be placed under ultrasound control.

In palliative care, PEG tube are inserted in these two clinical scenarios. The first occurs in a patient with oesophageal malignancy who cannot maintain adequate nutrition or experiences distressing symptoms of hunger. The second occurs in a patient with abdominal carcinomatosis and bowel obstruction. The traditional method uses nasogasric tube. But this led to problems of aspiration, alar necrosis, haemorrhage and oesophageal-gastric erosions. The PEG tube overcomes these problems.

One study showed all palliative patients received good relief of nausea, vomiting, and some improvement in abdominal pain.