Cutaneous Myiasis Around Gastrostomy (PEG) Tube Insertion Site: The Second Case Report

Background: Myiasis refers to the infestation of live human with 2-winged larvae (maggots). Cutaneous myiasis is the most commonly encountered clinical form. It is divided into 3 main forms: furuncular, creeping (migratory), and wound (traumatic) myiasis. Case report: In this article, we report an extremely rare case of myiasis around percutaneous endoscopic gastrostomy (PEG) tube in a 71-year-old female patient. She had the tube placed for feeding purposes, 8 months prior to her presentation. Family noticed alive worms emerging from skin at the gastrostomy tube insertion site. Patient was treated conservatively with daily dressing with no debridement or use of systemic agents. Conclusions: PEG tube cutaneous myiasis is an extremely rare disease. Conservative management with petroleum-based and sterilizing agents is shown to be efficient to clear the disease in a short period of time.

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Current microbiology of percutaneous endoscopic gastrostomy tube (PEG tube) insertion site infections in patients with cancer

Supportive Care in Cancer ◽

10.1007/s00520-011-1177-x ◽

2011 ◽

Vol 19 (8) ◽

pp. 1267-1271 ◽

Cited By ~ 10

Author(s):

Kenneth V. I. Rolston ◽

Coralia Mihu ◽

Jeffrey J. Tarrand

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Current Microbiology ◽

Insertion Site ◽

Gastrostomy Tube ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Tube Insertion ◽

Patients With Cancer ◽

Endoscopic Gastrostomy ◽

Peg Tube

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Treatment of chronic hepatitis C virus infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy tube in a patient with HIV coinfection

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa328 ◽

2020 ◽

Vol 78 (1) ◽

pp. 36-40

Author(s):

Vanessa Huffman ◽

Diana C Andrade ◽

Elizabeth Sherman ◽

Jianli Niu ◽

Paula A Eckardt

Keyword(s):

Case Report ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Percutaneous Endoscopic Gastrostomy ◽

Fixed Dose ◽

Pharmacokinetic Data ◽

Percutaneous Endoscopic Gastrostomy Tube ◽

Endoscopic Gastrostomy ◽

Hiv Coinfection ◽

Peg Tube

Abstract Purpose Ledipasvir/sofosbuvir is an oral combination therapy containing fixed doses of direct-acting antiviral agents indicated for the treatment of hepatitis C virus (HCV) infection. Currently there are limited data on the clinical efficacy of crushed ledipasvir/sofosbuvir administered via feeding tube. Summary This case report discusses the successful treatment of chronic HCV genotype 1b infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy (PEG) tube in a patient with human immunodeficiency virus (HIV) coinfection and high-grade sarcoma who had severe swallowing difficulties. The patient received crushed ledipasvir/sofosbuvir daily for a total of 12 weeks. At 12 weeks the patient had achieved a sustained virologic response. Conclusion Currently, ledipasvir/sofosbuvir is available only as a tablet, with limited pharmacokinetic data available to guide clinicians on use of the fixed-dose combination medication in crushed form. This case report highlights our experience treating a patient with HCV/HIV coinfection through administration of crushed ledipasvir/sofosbuvir via PEG tube, which we found to be a safe and effective therapeutic option.

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Unexpected Migration Of Peripherally Inserted Central Catheter (PICC) Tip After Percutaneous Endoscopic Gastrostomy (PEG) Tube Insertion And Manipulation

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a5982 ◽

2012 ◽

Author(s):

Bashar I. Farjo ◽

Iman A. Hassan ◽

Pamela C. Carter

Keyword(s):

Percutaneous Endoscopic Gastrostomy ◽

Peripherally Inserted Central Catheter ◽

Central Catheter ◽

Tube Insertion ◽

Endoscopic Gastrostomy ◽

Peg Tube

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CC-011 Case report: colocutaneous fistula – a rare complication of PEG tube insertion

Gut ◽

10.1136/gut.2009.209080x ◽

2010 ◽

Vol 59 (Suppl 1) ◽

pp. A170.1-A170

Author(s):

A M Verma ◽

J A D Stewart

Keyword(s):

Case Report ◽

Rare Complication ◽

Tube Insertion ◽

Colocutaneous Fistula ◽

Peg Tube

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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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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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