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Cologastric fistula as a complication of percutaneous endoscopic gastrostomy
M M Stefan1, G W Holcomb, A J Ross
1Department of Surgery, Children's Hospital of Philadelphia, Pennsylvania 19104.
Insights
A rare cologastric fistula complication following percutaneous endoscopic gastrostomy (PEG) occurred in two pediatric patients. Technical adjustments during PEG placement may prevent this serious gastrointestinal issue.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Surgery
- Endoscopic Procedures
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a common procedure for enteral nutrition and decompression.
- Complications, though rare, can arise from PEG placement.
- Cologastric fistula is an infrequent but serious complication.
Observation:
- Two pediatric cases of cologastric fistula following PEG placement were recently identified.
- One fistula persisted even after the gastrostomy tube was removed.
Findings:
- A specific mechanism for the development of cologastric fistula post-PEG in these pediatric cases is proposed.
- Technical aspects of PEG placement are highlighted as crucial for preventing this rare complication.
Implications:
- Understanding the proposed mechanism can guide preventative measures during PEG procedures in children.
- Awareness of this rare complication is important for pediatricians and surgeons performing PEG.
Abstract:
Percutaneous endoscopic gastrostomy (PEG) is frequently used for long-term enteral nutrition or gastrointestinal decompression in both adults and children. The rare complication of a cologastric fistula following PEG has been seen recently in two pediatric patients. One fistula did not close after removal of the gastrostomy tube. A mechanism for the occurrence of this complication in these two children is proposed and technical points are emphasized to prevent this complication.