Warner Matthew, Durrani Muhammad
Inspira Medical Center, Department of Emergency Medicine, Vineland, New Jersey.
Clin Pract Cases Emerg Med. 2020 Nov;4(4):632-633. doi: 10.5811/cpcem.2020.7.48335.
A 48-year-old-female presented to the emergency department with dislodgement of her percutaneous endoscopic gastrostomy (PEG) tube, necessitating bedside replacement. Replacement was done without difficulty and gastrografin radiography was obtained to confirm positioning. Radiography revealed contrast filling the colon at the splenic flexure and proximal descending colon suggestive of colocutaneous fistula formation.
The patient required hospitalization with surgical consultation, initiation of parenteral nutrition, and conservative management of the fistula with surgical replacement of the PEG tube. Although rare, it is paramount for the emergency physician to be aware of this complication when undertaking bedside replacement of PEG tubes.
一名48岁女性因经皮内镜下胃造口术（PEG）管移位至急诊科，需要在床边更换。更换过程顺利，术后行泛影葡胺造影以确认位置。造影显示造影剂充盈脾曲和降结肠近端的结肠，提示结肠皮肤瘘形成。
患者需要住院并进行外科会诊，开始肠外营养，并对瘘管进行保守治疗，同时手术更换PEG管。尽管这种情况罕见，但对于急诊医生来说，在床边更换PEG管时意识到这种并发症至关重要。
