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Pneumoperitoneum with subcutaneous emphysema after percutaneous endoscopic gastrostomy.

Iscan Y, Karip B, Ozcabi Y, Ağca B, Alahdab Y, Memisoglu K - Case Rep Surg (2014)

Bottom Line: Percutaneous endoscopic gastrostomy is a safe way for enteral nutrition in selected patients.Generally, complications of this procedure are very rare but due to patients general health condition, delayed diagnosis and treatment of complications can be life threatening.In this study, we present a PEG-related massive pneumoperitoneum and subcutaneous emphysema in a patient with neuro-Behçet.

View Article: PubMed Central - PubMed

Affiliation: General Surgery, Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, İçerenköy, 34752 İstanbul, Turkey.

ABSTRACT
Percutaneous endoscopic gastrostomy is a safe way for enteral nutrition in selected patients. Generally, complications of this procedure are very rare but due to patients general health condition, delayed diagnosis and treatment of complications can be life threatening. In this study, we present a PEG-related massive pneumoperitoneum and subcutaneous emphysema in a patient with neuro-Behçet.

No MeSH data available.


Related in: MedlinePlus

Replaced PEG catheter in the stomach and resolved pneumoperitoneum.
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fig3: Replaced PEG catheter in the stomach and resolved pneumoperitoneum.

Mentions: Enteral feeding was stopped and intravenous hyperalimentation was given after repositioning of the tube. Because of the fever and high levels of CRP, blood, urine, and deep tracheal aspiration (DTA) cultures were obtained. The culture results of DTA were positive for Klebsiella pneumonia so Ertapenem therapy was ordered according to the antibiogram results. The subcutaneous emphysema resolved within 7 days. We started enteral nutrition again seven days after admission, but there was a leakage back to the skin around the PEG tube. We replaced the PEG-tube with a 20-F foley catheter and fixed it to the skin with sutures. After this replacement, tube feeding was resumed successfully for seven days. On the fourteenth day of her admission, a new PEG catheter was inserted from another part of the stomach and the transient foley catheter was removed. No recurrence of leakage, pneumoperitoneum, and emphysema developed (Figure 3). She was discharged seventeen days after her admission.


Pneumoperitoneum with subcutaneous emphysema after percutaneous endoscopic gastrostomy.

Iscan Y, Karip B, Ozcabi Y, Ağca B, Alahdab Y, Memisoglu K - Case Rep Surg (2014)

Replaced PEG catheter in the stomach and resolved pneumoperitoneum.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4120915&req=5

fig3: Replaced PEG catheter in the stomach and resolved pneumoperitoneum.
Mentions: Enteral feeding was stopped and intravenous hyperalimentation was given after repositioning of the tube. Because of the fever and high levels of CRP, blood, urine, and deep tracheal aspiration (DTA) cultures were obtained. The culture results of DTA were positive for Klebsiella pneumonia so Ertapenem therapy was ordered according to the antibiogram results. The subcutaneous emphysema resolved within 7 days. We started enteral nutrition again seven days after admission, but there was a leakage back to the skin around the PEG tube. We replaced the PEG-tube with a 20-F foley catheter and fixed it to the skin with sutures. After this replacement, tube feeding was resumed successfully for seven days. On the fourteenth day of her admission, a new PEG catheter was inserted from another part of the stomach and the transient foley catheter was removed. No recurrence of leakage, pneumoperitoneum, and emphysema developed (Figure 3). She was discharged seventeen days after her admission.

Bottom Line: Percutaneous endoscopic gastrostomy is a safe way for enteral nutrition in selected patients.Generally, complications of this procedure are very rare but due to patients general health condition, delayed diagnosis and treatment of complications can be life threatening.In this study, we present a PEG-related massive pneumoperitoneum and subcutaneous emphysema in a patient with neuro-Behçet.

View Article: PubMed Central - PubMed

Affiliation: General Surgery, Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, İçerenköy, 34752 İstanbul, Turkey.

ABSTRACT
Percutaneous endoscopic gastrostomy is a safe way for enteral nutrition in selected patients. Generally, complications of this procedure are very rare but due to patients general health condition, delayed diagnosis and treatment of complications can be life threatening. In this study, we present a PEG-related massive pneumoperitoneum and subcutaneous emphysema in a patient with neuro-Behçet.

No MeSH data available.


Related in: MedlinePlus