Enterocutaneous fistula: A rare complication of PEG tube placement

Quadri, A; Puetz, Thomas R.; Dindzans, Vincents J.; Canga, Cristino; Sincaban, Marilyn

doi:10.1067/mge.2001.113091

Cited by 10 publications

(6 citation statements)

References 11 publications

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“…Our results also demonstrated the similar level of safety with PEG-tube placement such as infection at the PEG-tube site. Likewise, no major long- term complications were noticed such as early mortality and fistula formation in the present series of patients [17,18]. …”

Section: Discussionmentioning

confidence: 71%

Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG) tube placement- patients' and care givers' perspectives

et al. 2006

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BackgroundPercutaneous endoscopic gastrostomy tube has now become a preferred option for the long-term nutritional support device for patients with dysphagia. There is a considerable debate about the health issues related to the quality of life of these patients. Our aim of the study was to assess the outcome and perspectives of patients/care givers, about the acceptability of percutaneous endoscopic gastrostomy tube placement.MethodsThis descriptive analytic study conducted in patients, who have undergone percutaneous endoscopic gastrostomy tube placement during January 1998 till December 2004. Medical records of these patients were evaluated for their demographic characteristics, underlying diagnosis, indications and complications. Telephonic interviews were conducted till March 2005, on a pre-tested questionnaire to address psychological, social and physical performance status, of the health related quality of life issues.ResultsA total of 191 patients' medical records were reviewed, 120 (63%) were males, and mean age was 63 years. Early complication was infection at PEG tube site in 6 (3%) patients. In follow up over 365 ± 149 days, late complications (occurring 72 hours later) were infection at PEG tube site in 29 (15 %) patient and dislodgment/blockage of the tube in 26 (13.6%). Interviews were possible with 126 patients/caretakers. Karnofsky Performance Score of 0, 1, 2, 3 and 4 was found in 13(10%), 18(14%), 21(17%), 29(23%) and 45(36%) with p-value < 0.001. Regarding the social and psychological aspects; 76(60%) would like to have the PEG tube again if required, 105(83 %) felt ease in feeding, and 76(60%) felt that PEG-tube helped in prolonging the survival. Regarding negative opinions; 49(39 %) felt that the feeding was too frequent, 45(36 %) felt apprehensive about dependency for feeding and 62(49%) were concerned about an increase in the cost of care.ConclusionPEG-tube placement was found to be relatively free from serious immediate and long- term complications. Majority of caregivers and patient felt that PEG-tube helped in feeding and prolonging the survival. Studies are needed to assess the real benefit in terms of actual nutritional gain and quality of life in such patients.

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Section: Discussionmentioning

confidence: 71%

Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG) tube placement- patients' and care givers' perspectives

et al. 2006

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“…A proper technique of transillumination, finger indentation of the ventral abdominal wall, and observation of any gas bubble aspirated from the injecting needle before entrance into the stomach during the operation can minimize the risk of interposition of the colon or small bowel [5, 10, 15]. In our patient, the internal bumper of the gastrostomy tube was initially confirmed to be in situ at the time of insertion 8 years ago.…”

Section: Discussionmentioning

confidence: 93%

“…In our patient, although she received the gastrostomy at an adult age of 27 years, her body weight of 32 kg and lack of muscle mass made her mimicking a paediatric body build and rendered her to be at a higher risk than a usual adult. Other risk factors in previous reports include spinal kyphoscoliosis, prior abdominal surgery and adhesion, and overinflation of the stomach causing anterior rotation of the greater curvature of the stomach [10, 11, 14, 15]. …”

Section: Discussionmentioning

confidence: 99%

“…The presentation includes diarrhoea upon tube feeding, faecal discharge from the tube, weight loss, abdominal pain, intestinal obstruction, and difficulty in tube exchange and also acute peritonitis after procedure [6, 9, 11, 12, 15]. The time from PEG to symptom presentation or diagnosis ranges from the period immediate after insertion to a longest 3 years of duration [9, 11, 16].…”

Section: Discussionmentioning

confidence: 99%

“…Enterocutaneous fistula, on the other hand, is much more infrequent. To date, only 3 cases of small bowel fistula created through endoscopic gastrostomy insertion were described in English literature [13, 15, 17]. In contrast to colocutaneous fistula, enterocutaneous fistula is often less symptomatic and usually only presents as mild bilious fluid leakage around the gastrostomy tube or even being completely asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A Silent and Chronic Complication of Percutaneous Endoscopic Gastrostomy Tube: Small Bowel Enterocutaneous Fistula

Cheung

2016

Case Reports in Gastrointestinal Medicine

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Percutaneous endoscopic gastrostomy (PEG) has gradually gained the popularity since its invention and become the most preferred method for gastrostomy insertion in recent years. PEG is associated with lower morbidity and mortality and has the advantages of being minimally invasive and more convenient over the conventional open gastrostomy. However, significant rates of major complication still occur. Enterocutaneous fistula is one of the key complications that can be easily neglected due to its asymptomatic nature. We present a case of small bowel enterocutaneous fistula which was only found 8 years after the PEG insertion, being diagnosed after the longest duration of delay in diagnosis reported in literature.

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Complications of percutaneous endoscopic gastrostomy

Willandt¹,

Vandervoort

2015

Gastrointestinal Emergencies

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Enterocutaneous fistula: A rare complication of PEG tube placement

Cited by 10 publications

References 11 publications

Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG) tube placement- patients' and care givers' perspectives

Acceptability and outcomes of the Percutaneous Endoscopic Gastrostomy (PEG) tube placement- patients' and care givers' perspectives

A Silent and Chronic Complication of Percutaneous Endoscopic Gastrostomy Tube: Small Bowel Enterocutaneous Fistula

Complications of percutaneous endoscopic gastrostomy

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