Ahmad Jawad, Thomson Stacey, McFall Branden, Scoffield Julie, Taylor Mark
Surgery, Mater Hospital Belfast, Belfast, UK.
BMJ Case Rep. 2010 Nov 12;2010:bcr0520102976. doi: 10.1136/bcr.05.2010.2976.
Percutaneous endoscopic gastrostomy (PEG) is a common practice usually offered to patients who are unable to tolerate or swallow oral feed and require long-term nutrition. We present a case of early pneumoperitoneum after a PEG placement due to colonic perforation. The patient was severely malnourished and had a medical history of brain injury, cerebrovascular accident cerebrovascular accident (CVA) and bilateral below knee amputations from a bomb blast 13 years ago. The PEG tube was placed under sedation. On the first postoperative day, the patient had a subtle pneumoperitoneum that was considered secondary to the procedure. On the third postoperative day, the patient became tachycardiac with abdominal distension. A CT scan showed the PEG tube traversing through the transverse colon. The patient underwent a laparotomy and repair of colonic injury and made an uneventful recovery.
经皮内镜下胃造口术（PEG）是一种常见的操作，通常用于那些无法耐受或吞咽口服食物且需要长期营养支持的患者。我们报告一例PEG置管后因结肠穿孔导致早期气腹的病例。该患者严重营养不良，有脑损伤病史、脑血管意外（CVA）以及13年前因炸弹爆炸导致的双侧膝下截肢史。PEG管在镇静状态下置入。术后第一天，患者出现轻微气腹，考虑与手术有关。术后第三天，患者出现心动过速和腹胀。CT扫描显示PEG管穿过横结肠。患者接受了剖腹手术和结肠损伤修复，恢复顺利。
