Ann Rehabil Med.  2011 Dec;35(6):954-957. 10.5535/arm.2011.35.6.954.

A Nasogastric Tube Inserted into the Gastrocutaneous Fistula

• Kim YS
• Kim JS
• Yu IH
• Jeong JY
• Jung SH
• Jo YR
• Chung ME

• KMID: 2266825
• DOI: http://doi.org/10.5535/arm.2011.35.6.954

Abstract

We reported a case in which a nasogastric tube was inserted into the gastrocutaneous fistula, diagnosed by abdominal computed tomography. A 78-year-old man with a history of recurrent cerebral hemorrhage had a percutaneous endoscopic gastrostomy tube due to dysphagia for 2 years. However, soft tissue infection at the gastrostomy site caused the removal of the tube. Immediately, antibiotic agents were infused. For appropriate hydration and medication, a nasogastric tube was inserted. However, there was no significant improvement of the soft tissue infection. Moreover, the amount of bloody exudate increased. Abdominal computed tomography revealed the nasogastric tube placed under the patient's skin via gastrocutaneous fistula. The nasogastric tube was removed, and an antibiotic agents were maintained. After 3 weeks, the signs of infection fully improved, and percutaneous endoscopic gastrostomy was performed again. This case shows necessities of an appropriate interval between removal of the gastrostomy tube and insertion of a nasogastric tube, and suspicion of existence of gastrocutaneous fistula.

Keyword

Gastrocutaneous fistula; Percutaneous endoscopic gastrostomy; Nasogastric tube

MeSH Terms

Aged
Cerebral Hemorrhage
Deglutition Disorders
Exudates and Transudates
Fistula
Gastrostomy
Humans
Skin
Soft Tissue Infections

Figure

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  Fig. 1 Erythematous skin is observed in the gastrostomy site after removal of tube.

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  Fig. 2 CT findings show a transverse cut (A) and a coronal cut (B) of nasogastric tube placed beneath the skin via gastrocutaneous fistula.

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