Clinical Case Database / Category: Clinical Care

Percutaneous endoscopic gastrostomy (PEG)

Publication details

Nasser Khan, Dr Steven Mann
Foundation Years Journal, volume 3, issue 4, p.38 (123Doc Education, London, May 2009)


A 79-year-old lady presented to the A&E with sudden onset dysarthria, dehydration and left-sided weakness. She had a history of previous transient ischaemic attacks and hypertension. She lived alone and was self-caring with a supportive family. On examination she had a dense left hemiplegia and dysarthria. A CT scan confirmed an early right cerebral hemisphere infarct and she was transferred to the stroke ward. Over the next 48 hours, the patient was assessed by the speech and language therapist who concluded that, as a result of her stroke, she was at significant risk of aspiration from her impaired swallow. A nasogastric feeding tube was passed and feeding commenced. Two weeks later, she was clinically stable with little signs of recovery and was still dysphagic and dysarthric with a hemiplegia. She remained at risk of aspiration according to the speech and language therapist assessment.

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Nasser Khan

Specialist Registrar in Gastroenterology
Barnet Hospital
Wellhouse Lane
Herts EN5 3DJ

Dr Steven Mann

Consultant Gastroenterologist
Barnet Hospital
Wellhouse Lane
Herts EN5 3DJ


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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