An unusual complication following radiological percutaneous gastrostomy

Area of Science:

• Gastroenterology
• Surgical Complications
• Pediatric Surgery

Background:

• Intestinal malrotation is a congenital anomaly primarily diagnosed in childhood.
• Its rarity in adults can lead to missed diagnoses in routine clinical settings.
• Undiagnosed malrotation poses a risk for catastrophic sepsis during medical procedures.

Purpose of the Study:

• To highlight the potential for missed intestinal malrotation in adult patients.
• To emphasize the importance of a high index of suspicion for malrotation in adults undergoing procedures.
• To illustrate how malrotation can complicate seemingly routine interventions.

Main Methods:

• Case presentation of a patient with a tongue malignancy.
• Description of an elective feeding tube placement procedure.
• Analysis of an unexpected complication arising from malrotated large bowel.

Main Results:

• The patient experienced a severe complication during feeding tube placement.
• The complication was directly attributed to the presence of a malrotated large bowel.
• This case underscores the potential for serious adverse events in adult patients with undiagnosed malrotation.

Conclusions:

• Intestinal malrotation can transform simple procedures into complex, high-risk interventions.
• Clinicians must maintain a high index of suspicion for malrotation during procedures like percutaneous gastrostomy and entrostomy.
• Pre-procedural screening for malrotation is recommended when suspicion is present.