» Articles » PMID: 35719248

Persistent Diarrhoea After Percutaneous Endoscopic Gastrostomy (PEG) in Paediatric Patient: Lessons from a Complication

Overview
Publisher Wiley
Specialty Pediatrics
Date 2022 Jun 20
PMID 35719248
Authors
Affiliations
Soon will be listed here.
Abstract

Percutaneous endoscopic gastrostomy (PEG) is increasingly used in paediatric population. We report a case of a 4-year-old boy who, two weeks after PEG placement, presented persistent diarrhoea interpreted as intolerance to enteral feeding. His CT scan confirmed the correct placement of gastrostomy, but during gastroscopy, gastrostomy could not be found in the stomach, and the following colonoscopy revealed migration of gastrostomy to the transverse colon. The patient required removal of the misplaced PEG and conservative management of the fistula with surgical replacement of gastrostomy. We faced an unusual presentation of PEG placement complication due to colon interposition during blind gastric puncture. In children with anatomical deformities, previous surgery, or low weight or malnutrition (<10 kg), we suggest laparoscopic-assisted gastrostomy to avoid the risk of a major complication.

References
1.
Liu R, Jiwane A, Varjavandi A, Kennedy A, Henry G, Dilley A . Comparison of percutaneous endoscopic, laparoscopic and open gastrostomy insertion in children. Pediatr Surg Int. 2013; 29(6):613-21. DOI: 10.1007/s00383-013-3313-9. View

2.
Balogh B, Kovacs T, Saxena A . Complications in children with percutaneous endoscopic gastrostomy (PEG) placement. World J Pediatr. 2018; 15(1):12-16. DOI: 10.1007/s12519-018-0206-y. View

3.
Sakai H, Inamori M, Sato T, Tomimoto A, Akiyama T, Akimoto K . Colocutaneous fistula after percutaneous endoscopic gastrostomy. Digestion. 2007; 75(2-3):103. DOI: 10.1159/000104729. View

4.
Liu S, Ng S, Yip H, Teoh A, Chiu P, Ng E . Migration of a percutaneous endoscopic gastrostomy tube into the transverse colon: a forgotten cause of refractory diarrhea. Endoscopy. 2010; 42 Suppl 2:E324-5. DOI: 10.1055/s-0030-1255703. View

5.
Merli L, DE Marco E, Fedele C, Mason E, Taddei A, Paradiso F . Gastrostomy Placement in Children: Percutaneous Endoscopic Gastrostomy or Laparoscopic Gastrostomy?. Surg Laparosc Endosc Percutan Tech. 2016; 26(5):381-384. PMC: 5054954. DOI: 10.1097/SLE.0000000000000310. View