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Case report
Management of early PEG tube dislodgement: simultaneous endoscopic closure of gastric wall defect and PEG replacement
  1. Peter Cmorej,
  2. Matthew Mayuiers and
  3. Choichi Sugawa
  1. Department of Surgery, Wayne State University, Detroit, Michigan, USA
  1. Correspondence to Dr Choichi Sugawa, choichisugawa{at}msn.com

Abstract

A 53-year-old man with dysphagia underwent uneventful placement of a percutaneous endoscopic gastrostomy (PEG) tube for long-term enteral feeding access. 11 hours after the procedure, it was discovered that he had accidentally dislodged the feeding tube. On physical examination, he was found to have a benign abdomen without evidence of peritonitis or sepsis. He was observed overnight with serial abdominal examinations and nasogastric decompression. In the morning, he was taken back to the endoscopy suite where endoscopic clips were employed to close the gastric wall defect and a PEG tube was replaced at an adjacent site. The patient was fed 24 hours thereafter and discharged from the hospital 48 hours after the procedure. Early accidental removal of a PEG tube in patients without sepsis or peritonitis can be safely treated with simultaneous endoscopic closure of the gastrotomy and PEG tube replacement, resulting in earlier enteral feeding and shorter hospital stay.

  • parenteral/enteral feeding
  • stomach and duodenum
  • gastrointestinal surgery
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Footnotes

  • Contributors All three of the primary authors: PC, MM and CS have contributed equally to the conception of the submitted work as well as acquisition and interpretation of data. All three were involved equally in drafting the work and critically revising it.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin consent obtained.

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