Magacha Hezborn M, Andrews McKenna A, Nagpal Sagar, Vedantam Venkata
Internal Medicine, East Tennessee State University Quillen College of Medicine, Johnson City, USA.
Cureus. 2024 Oct 29;16(10):e72637. doi: 10.7759/cureus.72637. eCollection 2024 Oct.
Acute pancreatitis is characterized by the premature activation of pancreatic enzymes leading to autodigestion and inflammation, commonly caused by gallstones or chronic alcohol consumption. However, iatrogenic factors, such as migration of a percutaneous endoscopic gastrostomy (PEG) tube, can be a cause of acute pancreatitis but are less frequently reported in the literature. This is a case of a 77-year-old male patient with a medical history significant for myasthenia gravis with dysphagia requiring a PEG tube placement who presented with abdominal pain and elevated lipase levels. Imaging revealed that the PEG tube had moved further inside the stomach compressing the pancreatic duct, causing acute pancreatitis. Repositioning the tube relieved the obstruction and normalized the patient's lipase levels, emphasizing the need for regular monitoring of PEG tube placement to prevent such complications. Clinicians should consider PEG tube migration in the differential diagnosis of acute pancreatitis to ensure timely and effective management.
急性胰腺炎的特征是胰腺酶过早激活，导致自身消化和炎症，通常由胆结石或长期饮酒引起。然而，医源性因素，如经皮内镜下胃造口术（PEG）管移位，也可能是急性胰腺炎的病因，但在文献中的报道较少。本文报告一例77岁男性患者，有重症肌无力伴吞咽困难病史，需行PEG管置入术，现出现腹痛和脂肪酶水平升高。影像学检查显示，PEG管在胃内进一步移位，压迫胰管，导致急性胰腺炎。重新放置PEG管解除了梗阻，患者脂肪酶水平恢复正常，这强调了定期监测PEG管位置以预防此类并发症的必要性。临床医生在急性胰腺炎的鉴别诊断中应考虑PEG管移位，以确保及时有效的治疗。
