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Gastrojejunal fistula after insertion of percutaneous endoscopic gastrostomy

R Kubiak1, D T Wilcox, L Spitz

  • 1Department of Paediatric Surgery, Great Ormond Street Hospital for Children NHS Trust, London, England.

Insights

A percutaneous endoscopic gastrostomy tube migrated in a boy with cystic fibrosis, creating a gastrojejunal fistula. This rare complication highlights the importance of monitoring feeding tube placement in pediatric patients.

Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Surgery

Background:

  • Cystic Fibrosis (CF) management often requires nutritional support via gastrostomy tubes.
  • Percutaneous endoscopic gastrostomy (PEG) is a common method for enteral feeding in pediatric patients.

Observation:

  • A 12-year-old male patient with a history of cystic fibrosis presented with an unusual complication.
  • The patient's PEG device was found to have migrated from the stomach into the jejunum.

Findings:

  • The migration of the PEG device resulted in the formation of a gastrojejunal fistula.
  • This case represents a rare but significant complication of PEG tube placement in a pediatric CF patient.

Implications:

  • This case underscores the need for vigilance in monitoring PEG tube position in pediatric patients, especially those with underlying conditions like cystic fibrosis.
  • Understanding and preventing such migrations are crucial for maintaining effective nutritional support and avoiding further complications in CF care.

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