Misplacement of the PEG tube through the transverse colon, an uncommon but possible complication

Misplacement of the Percutaneous Endoscopic Gastrostomy (PEG) tube through the transverse colon mainly by traction is an uncommon complication probably due to inadvertent puncture of colon during PEG placement, resulting in gastrocolocutaneous fistula. Stool drainage through the stoma is usually the only symptom. We report a 52-year-old male with Wernicke-Korsakoff syndrome and PEG tube placement 7 months earlier and replacement one month ago. Due to stool drainage through the stoma was observed, he was performed a computed tomography (CT) in which PEG tube was visualized lodged in transverse colon without pneumoperitoneum associated. Due to important morbility, endoscopic management was decided. Balloon was removed through cutaneous orifice and Ovesco clip was placed simultaneously, achieving a complete closure of wall defect. Although spontaneous closure of the fistula usually happens, surgery is sometimes required, with endoscopic treatment being a less invasive and effective alternative to solve this complication.