Percutaneous Endoscopic Gastrostomy Tube Insertion-induced Superior Mesenteric Artery Injury Treated with Angiography

Lee, Seo Hee; Moon, Hee Seok; Park, Jae Ho; Kim, Ju Seok; Kang, Sun Hyung; Lee, Eaum Seok; Kim, Seok Hyun; Sung, Jae Kyu; Lee, Byung Seok

doi:10.4166/kjg.2018.72.6.308

Cited by 7 publications

(9 citation statements)

References 14 publications

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“…Regarding bleeding complications, specifically with blood vessel injury as the suspected cause, a list of previous reports have been summarized in Table 4. The arteries surrounding the stomach involved in such injuries included the gastroepiploic artery 16,17 , gastric artery 15,[18][19][20] , and splenic and superior mesenteric artery 14,21,22 . The artery injuries were caused by stomach rotation 17 , over-inflation of the stomach resulting in rotation 15 , multiple punctures 18,19,22 , loss of traction and torsional stress between ligaments and vessels 20 , and fibrosis and adhesions around the stomach due to postoperative cholecystectomy 14,21 .…”

Section: Discussionmentioning

confidence: 99%

Relationship of early acute complications and insertion site in push method percutaneous endoscopic gastrostomy

Suzuki

Joshita

Nagaya

et al. 2020

Sci Rep

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Percutaneous endoscopic gastrostomy (PEG), which is frequently used for nutrition management in patients having difficulty with oral intake, is considered a safe procedure. However, serious complications may occur depending on site of the puncture. This study aimed to clarify whether push method PEG construction at the posterior wall (PW) of the greater curvature (GC) had a higher risk of complications. We retrospectively investigated the relationship between puncture site at the PW of the GC and early acute complications in 540 patients receiving PEG. Early acute complications were defined as bleeding or perforation within 30 days after the PEG procedure. PEG-related complications were observed in 80 patients in total, with early acute complications detected in 42 patients. PEG construction at the PW of the GC in 12 cases exhibited a significantly higher occurrence of early acute complications versus PEG at other sites (41.7% vs. 7.0%, p = 0.001). Further, multivariate analysis revealed PW at the GC to be independently associated with early acute complications (OR 9.59, 95% CI 2.82–32.61; p = 0.0003). It may be desirable to avoid PEG at the PW of the GC. If performed, clinicians should pay careful attention to early acute complications.

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Section: Discussionmentioning

confidence: 99%

Relationship of early acute complications and insertion site in push method percutaneous endoscopic gastrostomy

Suzuki

Joshita

Nagaya

et al. 2020

Sci Rep

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“…It can occur from the gastrointestinal tract due to gastric ulcerations (80,81), the abdominal wall, or from injury to large vessels such as the gastric artery and splenic or mesenteric veins (82,83). Intra-or retroperitoneal bleeding (84) and rectus sheath hematoma (85) have also been reported.…”

Section: Bleedingmentioning

confidence: 99%

“…Rarely, intraluminal or intraperitoneal bleeding may require endoscopic or surgical exploration (66,86). Transarterial embolization of injured branches of larger vessels such as superior mesenteric artery to achieve hemostasis has also been described (82). Not surprisingly, coagulopathy, thrombocytopenia, and the use of anticoagulation increases bleeding risk (89,90).…”

Section: Bleedingmentioning

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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“…Bleeding from the gastric artery, superior mesenteric artery, splenic or mesenteric vein injuries have been reported. 49,50 Risk factors include anatomic aberration, anticoagulation, and antiplatelet therapy. 25 To prevent bleeding, with consideration of abnormal anatomy and correcting coagula- tion disorders before PEG tube placement can be useful.…”

Section: Bleedingmentioning

confidence: 99%

Percutaneous endoscopic gastrostomy

Liu

Yang

et al. 2021

Int J Gastrointest Interv

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Percutaneous endoscopic gastrostomy (PEG) is a feasible and safe technique for patients who need long-term feeding and cannot eat orally. With the increasing maturity of PEG technique, a large number of patients receive PEG tube placement every year in the world. However, PEG tube placement is not necessary in some patients, and some other patients are not evaluated strictly, leading to serious complications. In a broad sense, the mainly two indications for PEG include long-term enteral nutrition and gastric decompression. On the other hand, the main contraindications of PEG are distal intestinal obstruction, severe coagulation abnormalities, and severe infection at the PEG site. In the first section of this review, the indications and contraindications of PEG are introduced. Although PEG tube placement is a relatively safe technique, it can still cause a number of complications, including minor and major complications. Through standard management and treatment, the outcome of most patients is very good. In the second section of this review, we describe a variety of minor and major tube-related complications, and the treatment and prevention of these complications. In addition, the preparation and post-insertion care are also very important for PEG, which can reduce the incidence of complications. In the last section of this review, we describe related issues about the preparation and post-insertion care of PEG. In conclusion, PEG tube placement is a widely accepted technique that can bring benefits to the right patients.

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Percutaneous Endoscopic Gastrostomy Tube Insertion-induced Superior Mesenteric Artery Injury Treated with Angiography

Cited by 7 publications

References 14 publications

Relationship of early acute complications and insertion site in push method percutaneous endoscopic gastrostomy

Relationship of early acute complications and insertion site in push method percutaneous endoscopic gastrostomy

Managing complications of percutaneous tracheostomy and gastrostomy

Percutaneous endoscopic gastrostomy

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