Failure to transilluminate the stomach is not an absolute contraindication to PEG insertion.

Percutaneous endoscopic gastrostomy (PEG) tubes are now a well established method of enteral feeding. With the introduction of nurse endoscopists it has been possible to site PEG tubes with only one member of medical staff being present. Furthermore transillumination of the stomach is considered by many to be essential prior to gastric puncture. We present a series of 62 consecutive PEG tube sitings performed by the same nurse endoscopist/doctor team without transillumination of the stomach prior to gastric puncture. Sixty of the 62 patients (97 %) had successful PEG tube insertion. There were no immediate complications. There were two failures, neither of which related to the technique. It is concluded that failure of transillumination is not an absolute contraindication to PEG tube insertion.