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Published on: August 22, 2025

Occult abdominal wall peristomal abscess following percutaneous endoscopic gastrostomy

J J Payne-James1, M J Bray, S K Rana

  • 1Department of Gastroenterology and Nutrition, Central Middlesex Hospital, Acton Lane, London, UK.

Clinical Nutrition (Edinburgh, Scotland)
|October 1, 1990
PubMed

Insights

Peristomal abscess formation, a serious complication of percutaneous endoscopic gastrostomy (PEG) tube insertion, can be avoided by following strict protocols and administering prophylactic antibiotics. Early diagnosis and treatment, including tube removal and abscess drainage, are crucial.

Area of Science:

  • Gastroenterology
  • Surgical Complications
  • Infectious Disease

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a common procedure for enteral feeding.
  • Complications can arise, including infections and abscess formation around the stoma.
  • Peristomal abscess is a potentially serious, though infrequent, complication.

Purpose of the Study:

  • To report a case of peristomal abscess formation following PEG insertion.
  • To highlight the importance of prophylactic antibiotics and adherence to insertion protocols.
  • To discuss diagnostic and management strategies for peristomal abscesses.

Main Methods:

  • Case report detailing a patient who developed a peristomal abscess post-PEG insertion.
  • Review of the patient's treatment, including diagnosis and intervention.
  • Discussion of contributing factors, such as the absence of prophylactic antibiotics.

Main Results:

  • The patient developed a peristomal anterior abdominal wall abscess.
  • Abscess formation was associated with the lack of prophylactic antibiotic administration.
  • Successful treatment involved gastrostomy tube removal and abscess drainage.

Conclusions:

  • Strict adherence to PEG insertion protocols and prophylactic antibiotic use can prevent peristomal abscesses.
  • Early diagnosis is key, with ultrasonography being a useful tool for occult abscesses.
  • Prompt management, including drainage, is essential for favorable outcomes.

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