Case Report


Dangers associated with replacement of a percutaneous endoscopic gastrostomy tube: Report of a case of skewering of the stomach into the jejunum like a bridge

,  ,  ,  ,  

1 Department of Surgery, Yamamoto Memorial Hospital, Imari, Japan

2 Department of Internal Medicine, Yamamoto Memorial Hospital, Imari, Japan

Address correspondence to:

Kentaroh Yamamoto

MD, PhD, Department of Surgery, Yamamoto Memorial Hospital, Imari,

Japan

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Article ID: 101390Z01XB2023

doi: 10.5348/101390Z01XB2023CR

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How to cite this article

Bian X, Yamamoto K, Yamamoto M, Yamamoto F. Ogawa K. Dangers associated with replacement of a percutaneous endoscopic gastrostomy tube: Report of a case of skewering of the stomach into the jejunum like a bridge. Int J Case Rep Images 2023;14(1):89–93.

ABSTRACT


Introduction: Percutaneous endoscopic gastrostomy (PEG) is a relatively safe and effective method of providing nutrition to patients with neurologic deficits or proximal gastrointestinal disorders. Dislodgement, dysfunction, and infection are the reported complications associated with placement of a PEG tube. On the other hand, tract disruption and external displacement are the reported complications associated with replacement of a PEG tube. In all the external displacement cases following replacement of the PEG tube, the PEG tubes were displaced into the abdominal cavity. This is the first report of displacement of the PEG tube into the jejunum by accidental skewering of the tube through the stomach during its replacement.

Case Report: An 85-year-old woman presented to our hospital complaining of erosive dermatitis around the PEG tube. Two weeks prior to her present complaints, the PEG tube had been changed, following which she developed erosive dermatitis around the PEG tube. Abdominal computed tomography (CT) and gastroendoscopy revealed that the PEG tube had gone through the anterior wall to the posterior wall of the stomach, like a “bridge,” and skewered out of the stomach. A new PEG tube was positioned in the stomach and the tract to the jejunum was treated conservatively.

Conclusion: Although complications associated with replacement of the PEG tube are rare, replacement should be performed under gastroendoscopy to avoid these complications.

Keywords: Complications, Percutaneous endoscopic gastrostomy, Replacement

SUPPORTING INFORMATION


Author Contributions

Xueyi Bian - Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published

Kentaroh Yamamoto - Acquisition of data, Drafting the article, Final approval of the version to be published

Mami Yamamoto - Acquisition of data, Drafting the article, Final approval of the version to be published

Fumio Yamamoto - Acquisition of data, Drafting the article, Final approval of the version to be published

Kenichi Ogawa - Analysis of data, Drafting the article, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2023 Xueyi Bian et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.