A case of small-bowel obstruction after insertion of a percutaneous endoscopic gastrostomy tube due to mesenteric penetration

Roos, Justus E.

doi:10.1308/003588415x14181254790365

Cited by 8 publications

(11 citation statements)

References 5 publications

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“…In these cases, patients did not present known risk factors for intestinal volvulus. 7 , 8 Surgery revealed PEG tube insertion in two points of the jejunal mesentery, thereby acting as the axis around which the mesentery and small bowel were twisted. Clinical presentation was very similar, with both patients showing symptoms of intestinal occlusion or subocclusion.…”

Section: Discussionmentioning

confidence: 99%

“…SBV may be primary or secondary; primary volvulus is rare, mainly occurring in the neonatal period due to intestinal malrotation. There are a few reported cases of SBV after PEG placement where the PEG probe was found to have penetrated the mesentery root, thereby causing SBV 7,8…”

Section: Introductionmentioning

confidence: 99%

“…There are a few reported cases of SBV after PEG placement where the PEG probe was found to have penetrated the mesentery root, thereby causing SBV. 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

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Midgut Volvulus after Percutaneous Endoscopic Gastrostomy

Martins

Sousa

Pinho

et al. 2017

ACG Case Reports Journal

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We report a 47-year-old man who underwent endoscopic gastrostomy placement due to feeding refusal and regurgitation. Procedure was unremarkable. Two days later, the patient presented signs of intestinal obstruction. Computed tomography imaging showed a well-positioned gastrostomy tube, small pneumoperitoneum, and small bowel volvulus (SBV) in the upper right abdomen with proximal small bowel dilated loops. Exploratory laparotomy revealed mesenteric torsion, leading to SBV, with no evidence of intestinal malrotation. Volvulus was successfully untwisted via surgery. This case highlights to the possible association between SBV and gastrostomy placement.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Midgut Volvulus after Percutaneous Endoscopic Gastrostomy

Martins

Sousa

Pinho

et al. 2017

ACG Case Reports Journal

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“…Injuries to internal organs are extraordinarily infrequent and represent the most dreaded complication of PEG tube placement. These have been described as isolated case reports in the medical literature and involve injury to the small intestine [ 8 ], colon [ 9 , 10 ], mesentery [ 11 ] and liver.…”

Section: Introductionmentioning

confidence: 99%

Trans-Hepatic Percutaneous Endoscopic Gastrostomy Tube Placement: A Case Report of A Rare Complication and Literature Review

et al. 2018

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Percutaneous endoscopic gastrostomy (PEG) tubes have emerged as the standard of care for long-term enteral feeding. This procedure is relatively safe; however, complications do occur, and one of the most dreaded complications is trauma to the surrounding organs. Hepatic injury during PEG placement is an extremely rare complication of the PEG procedure, with a handful of cases described in the medical literature. We describe the case of an accidental trans-hepatic placement of a PEG tube in a 78-year-old morbidly obese female, even with excellent trans-illumination and manual external pressure achieved during endoscopic placement. Post-procedure, cross-sectional imaging of the abdomen showed a gastrostomy tube traversing the lateral margin of the liver with adjacent small hematoma. Physical exam was unremarkable for abdominal tenderness or guarding/rigidity, and no blood or drainage was noted at the site of PEG insertion. Enteral nutrition was started after 24 h of PEG tube insertion and patient tolerated well with no complications. The patient was discharged to a nursing home but unfortunately died the following week to an unknown cause.

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“…Other rare but serious complications include iatrogenic injury to surrounding organs such as the spleen, liver and bowel [ 1 ]. The incidence of small bowel injury is infrequent due to its position beneath the omentum; however, injury leading to obstruction and volvulus has been described in the literature [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

A rare case of percutaneous endoscopic gastrostomy causing a small bowel obstruction and subsequent bowel erosion

Lee

Zielinski

Bhinder

et al. 2018

Journal of Surgical Case Reports

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Gastrostomy tubes can be used to provide long-term nutrition and feeding when oral intake is not adequate. A rare but serious complication includes iatrogenic small bowel injury. The incidence of this is infrequent due to its position of the small bowel beneath the omentum, however, injury leading to obstruction and volvulus has been previously described in the literature. We present an unusual case of gastrostomy tube transection into omental fat causing a kink in the small bowel allowing for a transition point of obstruction and subsequent erosion of the gastrostomy tube into the small bowel.

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A case of small-bowel obstruction after insertion of a percutaneous endoscopic gastrostomy tube due to mesenteric penetration

Cited by 8 publications

References 5 publications

Midgut Volvulus after Percutaneous Endoscopic Gastrostomy

Midgut Volvulus after Percutaneous Endoscopic Gastrostomy

Trans-Hepatic Percutaneous Endoscopic Gastrostomy Tube Placement: A Case Report of A Rare Complication and Literature Review

A rare case of percutaneous endoscopic gastrostomy causing a small bowel obstruction and subsequent bowel erosion

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