No abstract

Percutaneous endoscopic gastrostomy (PEG) has become the procedure of choice for long-term enteral feeding. Complications are generally infrequent and often avoidable. We describe an unusual case in which a PEG tube bumper caused subcutaneous perforation of an ileostomy. After conservative treatment proved unsuccessful, revision of the ileostomy via a peristomal incision was performed, with good result. Caution must be exercised before considering the severance of a PEG tube at the skin, especially in patients with an ileostomy.

Colonogastric fistula, more commonly called "gastrocolic," is a rare complication of Crohn's colitis. The 17th incidence of this fistula is reported. Fecal halitosis is a prominent symptom. Barium enema is the most accurate diagnostic tool. Colonoscopy plays a role in delineating surgical therapy. The stomach resection is described. Because of its pathogenesis, the authors prefer to call this "colonogastric" fistula, rather than gastrocolic fistula.

We present a case of a 78-year-old woman with abdominal-wall muscle paralysis following cutaneous herpes zoster in the T12-L1 dermatomes. An EMG confirmed paralysis, and a CT scan ruled out fascial defect. The paralysis had completely resolved 1 year later. A review of the literature regarding these unusual sequelae of herpes zoster is presented.