Aparato Digestivo, Complejo Asistencial Universitario de León, españa.
Aparato Digestivo, Complejo Asistencial Universitario de León.
Rev Esp Enferm Dig. 2022 May;114(5):296-297. doi: 10.17235/reed.2022.8501/2021.
Misplacement of the Percutaneous Endoscopic Gastrostomy (PEG) tube through the transverse colon mainly by traction is an uncommon complication probably due to inadvertent puncture of colon during PEG placement, resulting in gastrocolocutaneous fistula. Stool drainage through the stoma is usually the only symptom. We report a 52-year-old male with Wernicke-Korsakoff syndrome and PEG tube placement 7 months earlier and replacement one month ago. Due to stool drainage through the stoma was observed, he was performed a computed tomography (CT) in which PEG tube was visualized lodged in transverse colon without pneumoperitoneum associated. Due to important morbility, endoscopic management was decided. Balloon was removed through cutaneous orifice and Ovesco clip was placed simultaneously, achieving a complete closure of wall defect. Although spontaneous closure of the fistula usually happens, surgery is sometimes required, with endoscopic treatment being a less invasive and effective alternative to solve this complication.
经皮内镜胃造口（PEG）管通过横结肠的位置错位主要是由于牵引引起的，这是一种不常见的并发症，可能是由于在 PEG 放置过程中无意中刺穿了结肠，导致胃结肠瘘。粪便通过造口排出是其唯一的症状。我们报告了一位 52 岁的男性，患有 Wernicke-Korsakoff 综合征和 7 个月前的 PEG 管放置以及一个月前的更换。由于观察到粪便通过造口排出，对他进行了计算机断层扫描（CT），结果显示 PEG 管位于横结肠内，没有与气腹相关的穿孔。由于存在严重的并发症，决定进行内镜治疗。球囊通过皮肤切口取出，同时放置 Ovesco 夹，实现了壁缺损的完全闭合。尽管瘘通常会自行闭合，但有时需要手术治疗，内镜治疗是解决这种并发症的一种微创且有效的替代方法。
