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Percutaneous endoscopic gastrostomy (PEG) is the most effective and least invasive method for enteral nutrition (EN). The most common system for PEG is the �pull� technique, which. It is not available in case endoscopy cannot be performed. The �push� technique may be an option if effective identification of the abdominal structures can be achieved. X-ray or ultrasonography can be used for that purpose. The aim was to assess the clinical value of ultrasound-guided �push� gastrostomy. A retrospective analysis of eleven patients (6 F, 5 M, mean age 65.1) including the procedure itself, complication rate, and cost was conducted. In all eleven patients the surgery was successful, and EN was introduced 4-6 hours afterwards. Complications included pain requiring removal of a supporting stitch (n = 1) and balloon deflation (n = 1). All patients were successfully fed enterally. Ultrasound-guided �push� technique gastrostomy should become a method of choice if the �pull� method is unavailable.
