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Persistent Diarrhoea after Percutaneous Endoscopic Gastrostomy (PEG) in Paediatric Patient: Lessons from a

Sara Silvaroli1, Filomena Valentina Paradiso1, Valentina Giorgio2

  • 1Unit of Paediatric Surgery, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, Rome 00168, Italy.

Case Reports in Pediatrics
|June 20, 2022
PubMed

Insights

A rare complication of percutaneous endoscopic gastrostomy (PEG) in a child involved the feeding tube migrating to the colon. Laparoscopic-assisted gastrostomy is recommended for high-risk pediatric patients.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Device Complications

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a common procedure for enteral feeding in children.
  • Complications, though infrequent, can occur and may require intervention.

Observation:

  • A 4-year-old boy developed persistent diarrhea post-PEG placement, initially thought to be feeding intolerance.
  • Imaging confirmed correct initial placement, but subsequent endoscopy revealed the PEG had migrated from the stomach to the transverse colon.

Findings:

  • The misplaced PEG necessitated its removal and surgical replacement of the gastrostomy.
  • The complication arose from colon interposition during the blind gastric puncture technique.

Implications:

  • This case highlights an unusual complication of PEG placement in pediatric patients.
  • Laparoscopic-assisted gastrostomy is suggested for children with risk factors like low weight, malnutrition, anatomical deformities, or prior surgery to mitigate risks.

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