Rectal Bleeding after Insertion of a Percutaneous Endoscopic Gastrostomy Tube

Iatrogenic injury to an internal organ such as the stomach, colon, small bowel, or liver after percutaneous endoscopic gastrostomy (PEG) tube insertion is a rare complication. We present a case of rectal bleeding due to colon injury during PEG tube placement. This required urgent exploratory laparoscopic surgery with segmental resection of the transverse colon and replacement of the PEG tube. Postoperatively, the patient significantly improved with time and tolerated PEG tube feeding.

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1897 Endoscopic Closure of GastroColoCutaneous Fistula: A Rare Complication of Percutaneous Endoscopic Gastrostomy Tube Placement

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000597120.85040.ee ◽

2019 ◽

Vol 114 (1) ◽

pp. S1060-S1061

Author(s):

Hassaan Zia ◽

Maham Hayat ◽

Ralph Guild

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Rare Complication ◽

Gastrostomy Tube ◽

Tube Placement ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Endoscopic Closure ◽

Gastrostomy Tube Placement

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Safety and efficacy of percutaneous endoscopic gastrostomy tube placement in patients with malignant peritoneal carcinomatosis induced bowel obstruction.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e14012 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e14012-e14012

Author(s):

Pankaj G Vashi ◽

Donald Peter Braun ◽

Brenten Popiel ◽

Digant Gupta

Keyword(s):

Peritoneal Carcinomatosis ◽

Bowel Obstruction ◽

Percutaneous Endoscopic Gastrostomy ◽

Insertion Site ◽

Tube Placement ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Safety And Efficacy ◽

Symptom Resolution ◽

Endoscopic Gastrostomy ◽

Peg Tube

e14012 Background: Percutaneous Endoscopic Gastrostomy (PEG) tube placement in advanced peritoneal carcinomatosis with bowel obstruction is a feasible palliative procedure to help patients with obstructive symptoms. We describe the safety and efficacy of using PEG tube for decompression in patients with large peritoneal masses. Methods: A consecutive case series of 62 patients (Apr-08 to Jun-11) with advanced abdominal carcinomatosis induced bowel obstruction. All patients were extensively treated for their cancer. None of them were surgical candidates due to extensive peritoneal involvement. All patients had symptoms of nausea, vomiting and pain at the time of PEG tube placement. All patients had a 28F (Bard) PEG tube placed for drainage. The primary outcomes of interest were complications and symptom resolution due to PEG tube placement. Frequency of nausea, vomiting and severity of pain was recorded daily in patient charts. Results: 16 were males and 46 females. The mean age was 50.5 years. Most common cancers were ovary, pancreas, colon and stomach. Of 62 patients, 57 patients had expired at the time of this analysis. Of those 57 expired, 49 had PEG tube at the time of death, while 8 had complete resolution of symptoms with PEG tube removed before death. The 5 out of 62 patients who are alive still have the PEG tube for drainage (average 70.4 days). The average duration of PEG tube placement for all patients combined was 70.9 days (range 6-312 days). Relief of nausea, vomiting and pain was observed in 53 (85.5%), 55 (88.7%) and 35 (56.5%) patients respectively. Of a total of 43 patients who had PEG tube placed for >= 30 days, 24 (56%) could continue with their chemotherapy cycles because of symptom resolution. Non life threatening complications of PEG tube placement were observed in 9 (14.5%) patients. 3 had infection at the insertion site, 2 had bleeding and 3 had leaking at the PEG tube site while 1 had aspiration. 6 (9.7%) patients required replacement of the PEG tube due to occlusion. Conclusions: Placement of PEG tube in presence of advanced peritoneal carcinomatosis is safe and effective in relieving obstructive symptoms as well as extending the period of active cancer therapy.

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Inadvertent Percutaneous Endoscopic Gastrostomy Tube Placement through the Transverse Colon to the Stomach Causing Intractable Diarrhea: A Case Report

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2011/849460 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

David T. Burke ◽

Andrew I. Geller ◽

Alexios G. Carayannopoulos ◽

Richard Goldstein

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Transverse Colon ◽

Delayed Diagnosis ◽

Tube Placement ◽

Common Mechanism ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Tube Removal ◽

Peg Tube

Background. Among patients with chronic disease, percutaneous endoscopic gastrostomy (PEG) tubes are a common mechanism to deliver enteral feedings to patients unable to feed by mouth. While several cases in the literature describe difficulties with and complications of the initial placement of the PEG, few studies have documented the effects of a delayed diagnosis of a misplaced tube. Methods. This case study reviews the hospitalization of an 82 year old male with an inadvertent placement of a PEG tube through the transverse colon. Photos of the placement in the stomach as well as those of the follow up colonoscopy, and a recording of the episodes of diarrhea during the hospitalization were made. Results. The records of this patient reveal complaints of gastrointestinal distress and diarrhea immediately after placement of the tube. Placement in the stomach was verified by endoscopy, with discovery of the tube only after a follow up colonoscopy. The tube remained in place after this discovery, and was removed weeks after the diarrhea was unsuccessfully treated with antibiotics. After tube removal, the patient recovered well and was sent home.

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The Challenging Buried Bumper Syndrome after Percutaneous Endoscopic Gastrostomy

Case Reports in Gastroenterology ◽

10.1159/000446018 ◽

2016 ◽

Vol 10 (2) ◽

pp. 224-232 ◽

Cited By ~ 7

Author(s):

Ibrahim Afifi ◽

Ahmad Zarour ◽

Ammar Al-Hassani ◽

Ruben Peralta ◽

Ayman El-Menyar ◽

...

Keyword(s):

Septic Shock ◽

Percutaneous Endoscopic Gastrostomy ◽

Rare Complication ◽

Kidney Injury ◽

Stomach Wall ◽

Rapid Progression ◽

Tube Insertion ◽

Endoscopic Gastrostomy ◽

Buried Bumper Syndrome ◽

Peg Tube

Buried bumper syndrome (BBS) is a rare complication developed after percutaneous endoscopic gastrostomy (PEG). We report a case of a 38-year-old male patient who sustained severe traumatic brain injury that was complicated with early BBS after PEG tube insertion. On admission, bedside PEG was performed, and 7 days later the patient developed signs of sepsis with rapid progression to septic shock and acute kidney injury. Abdominal CT scan revealed no collection or leakage of the contrast, but showed malpositioning of the tube bumper at the edge of the stomach and not inside of it. Diagnostic endoscopy revealed that the bumper was hidden in the posterolateral part of the stomach wall forming a tract inside of it, which confirmed the diagnosis of BBS. The patient underwent laparotomy with a repair of the stomach wall perforation, and the early postoperative course was uneventful. Acute BBS is a rare complication of PEG tube insertion which could be manifested with severe complications such as pressure necrosis, peritonitis and septic shock. Early identification is the mainstay to prevent such complications. Treatment selection is primarily guided by the presenting complications, ranging from simple endoscopic replacement to surgical laparotomy.

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Endoscopic Repair of Gastrocolic and Colocutaneous Fistulas Complicating Percutaneous Endoscopic Gastrostomy Tube

Case Reports in Gastrointestinal Medicine ◽

10.1155/2020/7262514 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Chukwunonso Chime ◽

Ahmed Baiomi ◽

Kishore Kumar ◽

Harish Patel ◽

Anil Dev ◽

...

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Tube Feeding ◽

Care Facility ◽

Index Patient ◽

Safe Procedure ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Term Care ◽

Long Term Care Facility ◽

Endoscopic Gastrostomy ◽

Peg Tube

Percutaneous endoscopic gastrostomy (PEG) tube feeding has become one of the options for supplemental feeding in a selected group of patients. It is a generally safe procedure usually undertaken by a gastroenterologist or a surgeon in most cases but with over 200,000 tubes being placed yearly, there is bound to be complications. Some of the encountered complications include bleeding, site infection, tube migration, and inadvertent creation of fistula. We present our index patient admitted from a long-term care facility for feculent vomiting and fecal material through the PEG tube. Imaging and colonoscopy confirmed the presence of both a gastrocolic and a colocutaneous fistula, both closed endoscopically with an over-the-scope and through-the-scope clips, respectively. Feeding through a nasogastric tube was resumed after 48 hours, and by the second week of admission, the patient was discharged back to the facility after placement of a new PEG tube.

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Meningitis Due to Enterobacter aerogenes Subsequent to Resection of Acoustic Neuroma and Percutaneous Endoscopic Gastrostomy Tube Placement: A Rare Nosocomial Event

Infection Control and Hospital Epidemiology ◽

10.1086/502135 ◽

2003 ◽

Vol 24 (10) ◽

pp. 780-782 ◽

Cited By ~ 2

Author(s):

David M. Poetker ◽

Charles E. Edmiston ◽

Michelle M. Smith ◽

Glenn A. Meyer ◽

Phillip A. Wackym

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Acoustic Neuroma ◽

Enterobacter Aerogenes ◽

Intervention Strategies ◽

Gastrostomy Tube ◽

Tube Placement ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Gastrostomy Tube Placement ◽

Peg Tube

AbstractWe present a case of meningitis after percutaneous endoscopic gastrostomy (PEG) tube placement subsequent to acoustic neuroma resection and cranioplasty. Four days following PEG tube placement the patient developed Enterobacter aerogenes meningitis, requiring explantation of infected cranioplasty material. His condition subsequently improved. Etiology and future intervention strategies are discussed (Infect Control Hosp Epidemiol 2003;24:780-782).

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