A Rare Case of Refeeding Syndrome Secondary to Percutaneous Endoscopic Gastrostomy (PEG) Tube Migration

2009 ◽  
Vol 104 ◽  
pp. S393
Author(s):  
Kristin Gaffney ◽  
Daniel Silbiger ◽  
Andrew Lazar
Author(s):  
Waka Yanagisawa ◽  
Daniel Oh ◽  
Dinushi Perera ◽  
Sebastian Rodrigues

Percutaneous endoscopic gastrostomy (PEG) tube is a common procedure. This discusses the rare complication of acute pancreatitis, due to tube migration, causing obstruction of the ampulla of Vater. Radiological confirmation of tubes prior to usage may aid in preventing this reversible complication.


2020 ◽  
Vol 78 (1) ◽  
pp. 36-40
Author(s):  
Vanessa Huffman ◽  
Diana C Andrade ◽  
Elizabeth Sherman ◽  
Jianli Niu ◽  
Paula A Eckardt

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.


2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Christopher Nonso Ekwunife ◽  
Kelechi E. Okonta ◽  
Stephen E. Enendu

Objectives: Percutaneous endoscopic gastrostomy (PEG) is a well-established endoscopic procedure that is used predominantly to create enteral access for feeding. Its use has not been widespread in Nigeria despite its efficacy. This study is done to review the early experiences in the use of PEG in Federal Medical Centre, Owerri and Carez Clinic, Owerri. Material and Methods: This is a 4-year retrospective cross-sectional study of patients who had PEG from January 2015 to December 2018. The indications, complications, and outcomes of the procedure were analyzed. Results: A total of 13 patients had pull-type gastrostomy during this period. Six (46.1%) patients had the procedure on account of neurologic disorders, 4 (30.8%) patients had esophageal tumors, while 3 (23.1%) patients had esophageal motility disorders. The overall success rate for PEG tube placement was 100%. The most common complication was superficial skin infection 30.8% (4/13). No mortality was attributable to the procedure. Conclusion: PEG is still not commonly done in our setting, but it is a relatively safe procedure. Physicians should be encouraged to offer it to our teeming patients with neurologic disorders who may benefit from it.


Endoscopy ◽  
2019 ◽  
Vol 51 (07) ◽  
pp. 689-693 ◽  
Author(s):  
Pieter Hindryckx ◽  
Barbara Dhooghe ◽  
Andreas Wannhoff

Abstract Background Buried bumper syndrome (BBS) is a complication of percutaneous endoscopic gastrostomy (PEG) in which the internal bumper is overgrown by the gastric mucosa. Apart from loss of patency of the PEG tube, the buried bumper may evoke symptoms such as abdominal pain or peritubular leakage. While the management of an incompletely buried bumper is fairly straightforward, this is not the case for a completely buried bumper. Different approaches to remove completely buried bumpers have been described, including endoscopic knife- or papillotome-based techniques. However, these devices are used off-label and the procedures can be laborious. Methods The Flamingo device has recently been introduced as the first tool specifically designed to remove a completely buried bumper. Results We describe the technique and our first experience in five patients with a completely (n = 4) or almost completely (n = 1) buried bumper. Fast and save removal of the buried bumper was obtained in all patients. Conclusion We believe that this device has the potential to become the standard first-line tool for the management of completely buried bumpers.


2019 ◽  
Vol 12 ◽  
pp. 117954761986900
Author(s):  
Mohammed N Bani Hani ◽  
Abdel Rahman Al Manasra ◽  
Hamzeh Daradkah ◽  
Farah Bani Hani ◽  
Zeina Bani Hani

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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