A Migrated Percutaneous Endoscopic Gastrostomy Tube Inducing Gastric Outlet Obstruction and Acute Pancreatitis

Dinh, Brian; Chen, Patrick; Beck, Gregory

doi:10.14309/00000434-201810001-01330

Cited by 2 publications

(1 citation statement)

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“…Occasionally, the external bolster can pull away from the abdominal wall, allowing migration of the gatrostomy tube into the stomach and duodenum, causing obstruction of pyloric area (133)(134)(135). This leads to crampy abdominal pain, nausea, and vomiting.…”

Section: Gastric Outlet Obstructionmentioning

confidence: 99%

Managing complications of percutaneous tracheostomy and gastrostomy

Zouk¹,

Batra²

2021

J Thorac Dis

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Percutaneous tracheostomy and gastrostomy are some of the most commonly performed procedures at bedside in the intensive care unit. While they are generally considered safe, they can be associated with numerous short and long-term complications, many of which can occur long after their placement and cause significant morbidity. Performers of these procedures should possess a comprehensive understanding of procedural indications and contraindications, and know how to recognize and manage complications that may arise. In this review, we highlight complications of percutaneous tracheostomy and describe strategies for their prevention and management, with a special focus on post-tracheostomy tracheal stenosis. Other complications reviewed include bleeding, pneumothorax and subcutaneous emphysema, posterior wall injury, tube displacement, tracheomalacia, tracheoinominate artery fistula, tracheo-esophageal fistula, and stomal cellulitis. Gastrostomy complications and their management are also discussed including bleeding, internal organ injury, necrotizing fasciitis, aspiration pneumonia, buried bumper syndrome, tumor seeding, wound infection, tube displacement, peristomal leakage, and gastric outlet obstruction. In light of the potentially serious outcomes associated with complications of percutaneous tracheostomy and gastrostomy, the emphasis should be placed on risk-reduction strategies to minimize morbidity and mortality.We therefore present detailed pragmatic and comprehensive checklists to serve as a reference for clinicians involved in performing these procedures.

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Section: Gastric Outlet Obstructionmentioning

confidence: 99%

Managing complications of percutaneous tracheostomy and gastrostomy

Zouk¹,

Batra²

2021

J Thorac Dis

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Migrated PEG balloon causing acute pancreatitis

et al. 2021

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Percutaneous endoscopic gastrostomy (PEG) is a common procedure for an unsafe swallow or inability to maintain oral nutrition. When a PEG tube needs replacement, a balloon gastrostomy tube is usually placed through the same, well formed and mature tract without endoscopy. We present a patient with a rare complication related to the balloon gastrostomy tube, to raise awareness and minimise the risk of this complication in the future. A 67-year-old female patient presented to the emergency department with severe abdominal pain and vomiting. Her gastrostomy feeding tube displaced inwards, up to the feeding-balloon ports complex. After investigations, she was diagnosed with acute pancreatitis. MR cholangiopancreatography (MRCP) confirmed features of this and, interestingly, an inflated gastrostomy balloon could be seen abutting the major and minor ampullae. The patient confirmed that the PEG tube had been changed to a balloon gastrostomy tube some time ago, but the external fixation plate (external bumper) had been loose lately, with the tube repeatedly moving inwards. She admitted that, 1 day before admission, the PEG tube had receded into the stomach and could not be pulled out with a gentle tug. After reviewing the MRCP images, the balloon was deflated, and the tube retracted. Once correctly placed, the balloon was reinflated, and her symptoms improved over the next 2 days.

show abstract

A Migrated Percutaneous Endoscopic Gastrostomy Tube Inducing Gastric Outlet Obstruction and Acute Pancreatitis

Cited by 2 publications

References 0 publications

Managing complications of percutaneous tracheostomy and gastrostomy

Managing complications of percutaneous tracheostomy and gastrostomy

Migrated PEG balloon causing acute pancreatitis

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