Gastrojejunal fistula after insertion of percutaneous endoscopic gastrostomy

Kubiak, Rainer; Wilcox, Duncan T.; Spitz, Lewis

doi:10.1016/s0022-3468(99)90172-0

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…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%

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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Section: Discussionmentioning

confidence: 99%

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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“…Leakage from the puncture site represents another post-procedural complication and is due to insufficient tension on the bumper. This inadequacy may also lead to dislocation of the bumper into the stomach or small bowel, resulting in obstruction [6,14]. While leakage is an early event, tension-related bumper migration occurs over time and is typically recorded as a late complication [8].…”

Section: Discussionmentioning

confidence: 99%

Emergency surgery for complications related to percutaneous endoscopic gastrostomy

Schulenberg

Schüle²,

Lehnert³

2010

Endoscopy

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Percutaneous endoscopic gastrostomy (PEG) is used to restore enteral nutrition in patients with inadequate oral intake. Because of its minimally invasive nature complications are thought to be rare. We analyzed data on all patients treated for PEG-related complications at the Department of General, Visceral, and Oncologic Surgery at the Klinikum Bremen-Mitte, Germany, between 2005 and 2008. A total of 38 patients with complications required surgical evaluation. Emergency laparotomy was performed for leakage in 16 patients, for a misplaced or dislodged PEG tube in nine patients, for buried bumper with accompanying signs of peritonitis in four patients and for gastrocutaneous fistula in one patient. Eight complications were managed conservatively. Early complications within 10 days (60 %) were related to leakage or mispositioning of the PEG, while PEG device migration and fistula formation represented late complications. Hospital mortality was 17 % with the underlying disease contributing significantly to the fatal outcome. Most PEG-associated major complications were related to technical errors and carried a high mortality.

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“…Options for gastrostomy tube placement include the open method, percutaneous endoscopic gastrostomy (PEG) placement, percutaneous placement under image guidance [3,10], and, most recently, laparoscopic gastrostomy placement [12]. Percutaneous endoscopic gastrostomy [1] has in recent years become the "gold standard" [15] but due to recognised complications [2,7,8,13] alternative minimally invasive methods are being sought. Overall, the rate of major complication was 17.5 % and included gastro-colocutaneous fistula (3 %), intestinal obstruction (3%), major haemorrhage (3 %) and gas-trostomy leaks causing peritonitis and requiring laparotomy (6%) [7].…”

Section: Discussionmentioning

confidence: 99%