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Missing PEG tube found at the ileocecal valve.
Soumya Kondaveety1,2, Lelan Bailey3, David P Blackwood1,2
1MedStar Harbor Hospital, Baltimore, MD.
Radiology Case Reports
|August 17, 2021
Summary
A migrated percutaneous endoscopic gastrostomy (PEG) tube caused obstruction in an elderly patient. Early detection via imaging is crucial for preventing serious complications like bowel obstruction.
Area of Science:
- Gastroenterology
- Medical Devices
- Diagnostic Imaging
Background:
- Percutaneous endoscopic gastrostomy (PEG) tubes facilitate alimentation in patients with dysphagia.
- While generally safe, PEG tube complications like obstruction due to migration can occur.
- Proximal migration is common, but distal migration to the large intestine is also documented.
Observation:
- An elderly patient with dementia and dysphagia presented with a missing PEG tube and no other symptoms.
- Initial investigations, including esophagogastroduodenoscopy, were inconclusive.
- A repeat PEG tube placement was performed.
Findings:
- Subsequent imaging revealed a foreign object in the right lower quadrant, suspected to be the migrated PEG tube.
- Computed tomography confirmed migration to the ileocecal valve.
- Colonoscopy successfully retrieved the dislodged PEG tube.
Implications:
- This case underscores the importance of considering distal PEG tube migration even without apparent symptoms.
- Vigilance is necessary to prevent severe complications such as small or large bowel obstruction.
- Highlights the role of advanced imaging and endoscopic procedures in diagnosing and managing rare PEG tube complications.
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