Korean J Gastroenterol.  2014 Feb;63(2):120-124. 10.4166/kjg.2014.63.2.120.

Two Cases of Uncommon Complication during Percutaneous Endoscopic Gastrostomy Tube Replacement and Treatment

• Lee HJ
• Choung RS
• Park MS
• Pyo JH
• Kim SY
• Hyun JJ
• Jung SW
• Koo JS
• Lee SW
• Choi JH

• KMID: 1730919
• DOI: http://doi.org/10.4166/kjg.2014.63.2.120

Abstract

We presented two interesting cases of gastrocolocutaneous fistula that occurred after percutaneous endoscopic gastrostomy (PEG) tube placement, and its management. This fistula is a rare complication that occurs after PEG insertion, which is an epithelial connection between mucosa of the stomach, colon, and skin. The management of the fistula is controversial, ranging from conservative to surgical intervention. Endoscopists should be aware of the possibility of gastrocolocutaneous fistula after PEG insertion, and should evaluate the risk factors that may contribute to the development of gastrocolocutaneous fistula before the procedure. We reviewed complications of gastrostomy tube insertion, symptoms of gastrocolocutaneous fistula, and its risk factors.

Keyword

Gastrostomy; Complication; Fistula

MeSH Terms

Aged
Cerebral Infarction/diagnosis
Digestive System Fistula/*etiology
Endoscopy, Gastrointestinal
Enteral Nutrition/*adverse effects/instrumentation
Gastrostomy
Humans
Male
Middle Aged
Nervous System Diseases/diagnosis
Risk Factors
Tomography, X-Ray Computed

Figure

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  Fig. 1. Percutaneous endoscopic gastrostomy tube penetrating the mid portion of the transverse colon.

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  Fig. 2. Percutaneous endoscopic gastrostomy tube passing through the transverse colon.

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  Fig. 3. Fistulous track between the abdominal wall and transverse colon.

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  Fig. 4. Fistular opening on the transverse colon.

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  Fig. 5. Clipping performed on the site of the fistular opening.

Reference

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