Pneumoperitoneum with Subcutaneous Emphysema after Percutaneous Endoscopic Gastrostomy

Abstract

Percutaneous endoscopic gastrostomy is a safe way for enteral nutrition in selected patients. Generally, complications of this procedure are very rare but due to patients general health condition, delayed diagnosis and treatment of complications can be life threatening. In this study, we present a PEG-related massive pneumoperitoneum and subcutaneous emphysema in a patient with neuro-Behçet.

A curious case of idiopathic subcutaneous emphysema

“…Behcet’s disease may predispose patients to develop subcutaneous emphysema. While more data are needed to determine whether a causal relationship exists, this is an observation based on ours and two previously reported cases [ 2 , 3 ].…”

Evaluation of a Trial of a Desufflation Technique to Decrease the Rate of Postoperative Pneumoperitoneum after Percutaneous Endoscopic Gastrostomy

“…1 Although PEG placement has been proven safe and effective with a perioperative mortality rate of 0 to 2 per cent and 30-day mortality rate of 5.8 to 6.5 per cent, occasionally hollow viscus injury with subsequent peritonitis and sepsis can occur. [2][3][4] Pneumoperitoneum (PNP) detected on postoperative radiographic imaging is usually benign but can be an indicator of a perforated viscus. 4 The probable etiology of PNP is leakage of air through the gastric wall due insufficient fixation of the tube or the escape of air through the stomach during the time between needle puncture and PEG tube passage.…”