scholarly journals Duodenal Pressure Necrosis in a Child Caused by a Migrated Percutaneous Endoscopic Gastrostomy

2020 ◽  
Vol 63 (2) ◽  
pp. 79-81
Author(s):  
Jan Melek ◽  
Markéta Štanclová ◽  
Radek Štichhauer ◽  
Pavel Rozsíval ◽  
Jan Kopřiva ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Food Refusal ◽  
Invasive Procedures ◽  
X Ray ◽  
Endoscopic Gastrostomy ◽  
Tertiary Centre ◽  
Pressure Necrosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Centre Hospital

A two-year-old girl with two weeks of abdominal pain, vomiting, and food refusal, ten months after percutaneous endoscopic gastrostomy insertion because of inadequate peroral intake, was admitted to a tertiary centre hospital. On admission, the extracorporeal part of the gastrostomy was much shortened. X-ray examination revealed migration of the end of the gastrostomy tube with a left-shifted course of the tube through the duodenum. Gastroscopy and subsequently laparotomy were performed. A longitudinal pressure necrosis was identified under the tube, with two perforations in the duodenojejunal region. Ten centimeters of that duodenojejunal region were resected, and end-to-end anastomosis was made. The migration of the gastrostomy was probably caused by insufficient care by the parents. Pathophysiologically, the tube caused the pressure necrosis in the duodenojejunal area; this was supported by histology. This is a hitherto undescribed complication of a percutaneous endoscopic gastrostomy, showing that migration of the gastrostomy to the deeper part of the small bowel can lead to pressure necrosis, a potentially life-threatening condition in children which cannot be treated without invasive procedures.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

scholarly journals X-RAY ENDOVASCULAR OCCLUSION IN ACUTE ARTERIAL BLEEDINGS FROM UPPER PARTS OF THE GASTROINTESTINAL TRACT IN CHILDREN

2018 ◽  
Vol 22 (1) ◽  
pp. 17-20
Author(s):  
I. A. Komissarov ◽  
N. A. Borisova ◽  
M. I. Komissarov ◽  
Ivan Yu. Aleshin
Keyword(s):  
Gastrointestinal Tract ◽  
X Ray ◽  
Endovascular Occlusion ◽  
Arterial Bleeding ◽  
Life Saving ◽  
Surgical Methods ◽  
Threatening Condition ◽  
Child Patient ◽  
Life Threatening ◽  
Endoscopic Methods

Acute arterial bleeding from the upper gastrointestinal tract (GIT) is a rare and life-threatening condition in children. The main method of instrumental examination in gastrointestinal hemorrhage (GIH) is fibro-esophagogastroduodenoscopy. If endoscopic diagnostics and hemostasis are ineffective, there are used other diagnostic and surgical methods of the treatment, which are associated with a high incidence of complications and high lethality. Methods of X-ray endovascular surgery, such as embolization of the arteries of the gastrointestinal tract, are life-saving and allow avoid severe traumatic surgical intervention. However, reports about the implementation of these methods in children are rare. We examined and treated 12 children with massive upper arterial GIHs. In 6 children it was managed to stop bleeding with the help of conservative and endoscopic methods of hemostasis. In 6 patients, these methods were ineffective, and they were underwent X-ray endovascular occlusion (XREO) of the blood vessels of the digestive tract. In 5 cases, embolization helped stop the bleeding after the first procedure, one child needed a repeat procedure for another source of the localization. In 6 cases, spirals were used as an embolization material, an autohemulation and microemboli were used in a one child patient. There were no complications associated with X-ray endovascular intervention. XREO is a minimally invasive and highly effective method of stopping the massive upper arterial GIH and can be performed even in children in extremely serious condition.

The Role of Mesna in the Treatment of Status Asthmaticus in Children

1979 ◽  
Vol 7 (5) ◽  
pp. 423-427 ◽  
Author(s):  
V Kyncl ◽  
J Pokorný ◽  
J Mega ◽  
V Skondia
Keyword(s):  
Status Asthmaticus ◽  
Blood Gas ◽  
X Ray ◽  
Bronchial Lavage ◽  
Threatening Condition ◽  
Life Threatening ◽  
Therapeutic Measures ◽  
Alveolar Gas Exchange ◽  
Parenteral Drug

Status asthmaticus in children is a life-threatening condition that calls for a comprehensive set of therapeutic measures, viz. evacuation of tracheobronchial secretions, parenteral drug administration and improvement of alveolar gas exchange. In the authors' experience, that therapeutic procedure can be much improved by bronchial lavage with mesna. This is illustrated by the good results obtained in fourteen patients with status asthmaticus and in another forty-four cases of global respiratory insufficiency. Evaluation was by blood gas values and X-ray pictures. The method used for bronchial lavage is described.

scholarly journals Pneumoperitoneum with Subcutaneous Emphysema after Percutaneous Endoscopic Gastrostomy

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Yalin Iscan ◽  
Bora Karip ◽  
Yetkin Ozcabi ◽  
Birol Ağca ◽  
Yesim Alahdab ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Subcutaneous Emphysema ◽  
General Health ◽  
Delayed Diagnosis ◽  
Health Condition ◽  
Diagnosis And Treatment ◽  
Endoscopic Gastrostomy ◽  
General Health Condition ◽  
Life Threatening

Percutaneous endoscopic gastrostomy is a safe way for enteral nutrition in selected patients. Generally, complications of this procedure are very rare but due to patients general health condition, delayed diagnosis and treatment of complications can be life threatening. In this study, we present a PEG-related massive pneumoperitoneum and subcutaneous emphysema in a patient with neuro-Behçet.

scholarly journals The Buried Bumper Syndrome: External Bumper Extraction after Radial Mini Incisions and Replacement through an Adjacent Tract

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
M. A. Benatta
Keyword(s):  
Nutritional Support ◽  
Laparoscopic Treatment ◽  
Abdominal Ct ◽  
Endoscopic Gastrostomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Adjacent Site ◽  
Buried Bumper Syndrome ◽  
Peg Tube

Although considered as a safe method to provide long-term nutritional support, percutaneous endoscopic gastrostomy (PEG) may be complicated by a buried bumper syndrome (BBS), a life-threatening condition. Removal of the PEG tube with its buried bumper and reinsertion of a new PEG tube is often necessary. Since its description in 1988, less than 50 cases of BBS managed by external extraction of the buried bumper have been reported. We report a case of buried bumper that was removed by external traction without the need for endoscopic or laparoscopic treatment but with the need of two radial millimeter skin incisions after abdominal CT study and finally immediate PEG replacement but through an adjacent site.

scholarly journals Successful Gastric Volvulus Reduction and Gastropexy Using a Dual Endoscope Technique

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Laith H. Jamil ◽  
Brian L. Huang ◽  
David C. Kunkel ◽  
Vijay Jayaraman ◽  
Edy E. Soffer
Keyword(s):  
Gastric Volvulus ◽  
Right Hemicolectomy ◽  
Whipple Procedure ◽  
Endoscopic Gastrostomy ◽  
Upper Gi Series ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Novel Strategy ◽  
Emergent Surgery

Gastric volvulus is a life threatening condition characterized by an abnormal rotation of the stomach around an axis. Although the first line treatment of this disorder is surgical, we report here a case of gastric volvulus that was endoscopically managed using a novel strategy. An 83-year-old female with a history of pancreatic cancer status postpylorus-preserving Whipple procedure presented with a cecal volvulus requiring right hemicolectomy. Postoperative imaging included a CT scan and upper GI series that showed a gastric volvulus with the antrum located above the diaphragm. An upper endoscopy was advanced through the pylorus into the duodenum and left in this position to keep the stomach under the diaphragm. A second pediatric endoscope was advanced alongside and used to complete percutaneous endoscopic gastrostomy (PEG) placement for anterior gastropexy. The patient’s volvulus resolved and there were no complications. From our review of the literature, the dual endoscopic technique employed here has not been previously described. Patients who are poor surgical candidates or those who do not require emergent surgery can possibly benefit the most from similar minimally invasive endoscopic procedures as described here.

Safely replacing a percutaneous endoscopic gastrostomy tube using a portable X-ray system at a patient’s home

2021 ◽  
Vol 14 (1) ◽  
pp. e238462
Author(s):  
Hitoshi Eguchi ◽  
Naoko E Katsuki ◽  
Ken-ichi Yamamoto ◽  
Masaki Tago
Keyword(s):  
Cerebral Infarction ◽  
Medical Care ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Guide Wire ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
X Ray ◽  
Endoscopic Gastrostomy ◽  
Tube Removal ◽  
Home Medical Care ◽  
Peg Tube

An 81-year-old woman who underwent percutaneous endoscopic gastrostomy (PEG) a year before, after cerebral infarction was receiving home medical care. The first accidental PEG tube removal occurred after clinic hours, and the home-care doctor visited her home to quickly reinsert the tube. After the narrowed fistula was dilated, the tube was reinserted with a guide wire. An X-ray taken with a CALNEO Xair, which is an easily portable X-ray system launched in 2018, confirmed that the tip of the PEG tube was successfully placed in the stomach. A similar accidental removal occurred 2 months later, and we managed it in the same way. Both events were resolved with a single radiograph without significant difficulty. With in-home medical care, PEG tube replacement can be performed easily and safely with a handy portable X-ray system.

scholarly journals Transhepatic Insertion of Percutaneous Endoscopic Gastrostomy Tube

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Zaid Imam ◽  
C. Roberto Simons-Linares
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Massive Bleeding ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Safe Procedure ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Life Threatening ◽  
Peg Tube

Inadvertent injury to interposing organs during percutaneous endoscopic gastrostomy (PEG) tube placement is a feared complication of this common and generally safe procedure. Transhepatic PEG insertion is likely an underrepresented complication which may be identified incidentally on imaging or present with life-threatening conditions such as sepsis or massive bleeding. Use of ultrasound in patients with known hepatomegaly may possibly help avoid this complication. We hereby report a case of transhepatic PEG insertion, one of 16 only other cases published in the literature, and review the characteristics of the previous reported cases.

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