Percutaneous endoscopic gastrostomy (PEG) is generally considered to be safe with a low rate of serious complications. However, dislocation of a gastrostomy tube can lead to serious complications.
The case report article describes a patient who presented to Dr. Imamura of Aichi Medical University Hospital. It was published on October 21 in the World Journal of Gastroenterology.
An 86-year-old woman with gastrostomy tube feeding sometimes vomited and complained of abdominal tenderness after her family doctor replaced the tube. Imaging studies showed the tip of the gastrostomy tube with the balloon had migrated into the second portion of the duodenum. They diagnosed acute pancreatitis and cholangitis secondary to duodenal obstruction. Her family doctor might have inserted the tube too deeply. After the tube was replaced, her symptoms improved immediately.
Five cases of acute pancreatitis related to gastrostomy tube migration have been reported. Dr. Imamura experienced a very rare complication of gastrostomy tube, and this case demonstrated that a malpositioned gastrostomy tube can be an iatrogenic cause of acute pancreatitis and cholangitis.
Reference: Imamura H, Konagaya T, Hashimoto T, Kasugai K. Acute pancreatitis and cholangitis: A complication caused by a migrated gastrostomy tube. World J Gastroenterol 2007; 13(39): 5285-5287
http://www.wjgnet.com/1007-9327/13/5285.asp
Correspondence to: Dr. Hiroshi Imamura, Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 21, Karimata, Yazako, Nagakute-cho, Aichi-gun, Aichi-ken, 480-1195,Japan. imamurah@aichi-med-u.ac.jp
Telephone: +81-561-623311 Fax: +81-561-621508
About World Journal of Gastroenterology:
World Journal of Gastroenterology (World J Gastroenterol, WJG), a leading international journal in gastroenterology and hepatology, has an established reputation for publishing fi rst class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection, providing a forum for both clinicians and scientists, and has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by The WJG Press. The publication date is 7th, 14th, 21st, and 28th every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No.30424812, which was founded with a name of China National Journal of New Gastroenterology on October 1, 1995, and renamed as WJG on January 25, 1998.
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World Journal of Gastroenterology