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- W2978295904 abstract "Percutaneous endoscopic gastrostomy (PEG) tubes are commonly indicated for providing enteric feedings for patients who are unable to maintain sufficient oral intake for various reasons. While PEG tube placement is considered to be a safe procedure, complications have been reported at a varying rate of 16 to 70 percent. Most complications are minor, with the most common complication being benign pneumoperitoneum. Major complications can include hemorrhage, perforation of the viscera leading to peritonitis, and necrotizing fasciitis, which is the rarest associated complication. This case presents a previously unreported cause of PEG tube displacement due to sigmoid volvulus. A 77 y/o male with a PMH of Parkinson's disease (PD) presented to our facility for PEG placement due to progressive dysphagia leading to increased aspiration risk. The patient denied previous abdominal surgeries. Careful examination of the stomach was performed via gastroscope and an area in the left upper quadrant was selected for placement. Good 1:1 visualization was selected and the PEG was inserted. A second visualization of the stomach was then performed and confirmed proper placement. Two days later, the patient was developed a leukocytosis, abdominal distention, and abdominal pain. CT scan demonstrated evidence of a sigmoid volvulus rising to the level of the diaphragm. Contrast confirmed appropriate PEG function inside the stomach. Within 12 hours, the patient's abdominal symptoms worsened, and he underwent an exploratory laparotomy. During laparotomy, the PEG tube was found to be displaced from the stomach into the peritoneum with greater omentum trapped in between the internal bumper and abdominal wall. Our case demonstrates the first ever report of PEG tube displacement into the peritoneum due to a sigmoid volvulus. This displacement by the sigmoid volvulus was only possible due to the greater omentum being traversed by the needle catheter during placement. As the sigmoid volvulus rose to the diaphragm, it caused the avulsion of the PEG tube's internal bumper into the peritoneum. What makes this case more unique is the fact that there appears to be no definitive etiology for the initial sigmoid volvulus. We postulate that the patient's chronic constipation due to PD and confounding anticholinergic therapy are the probable causes. This case is extraordinarily rare with no previously documented similar case reports found upon thorough literature review.Figure 1Figure 2" @default.
- W2978295904 created "2019-10-10" @default.
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- W2978295904 date "2016-10-01" @default.
- W2978295904 modified "2023-10-17" @default.
- W2978295904 title "The First Documented Case of Percutaneous Endoscopic Gastrostomy Tube Displacement Due to Omental Transversion and Sigmoid Volvulus" @default.
- W2978295904 doi "https://doi.org/10.14309/00000434-201610001-01546" @default.
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