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BMJ Case Rep. 2010; 2010: bcr0520102976.
Published online 2010 November 12. doi:  10.1136/bcr.05.2010.2976
PMCID: PMC3029591
Learning from errors

Colonic injury following percutaneous endoscopic-guided gastrostomy insertion

Abstract

Percutaneous endoscopic gastrostomy (PEG) is a common practice usually offered to patients who are unable to tolerate or swallow oral feed and require long-term nutrition.

We present a case of early pneumoperitoneum after a PEG placement due to colonic perforation. The patient was severely malnourished and had a medical history of brain injury, cerebrovascular accident cerebrovascular accident (CVA) and bilateral below knee amputations from a bomb blast 13 years ago.

The PEG tube was placed under sedation. On the first postoperative day, the patient had a subtle pneumoperitoneum that was considered secondary to the procedure. On the third postoperative day, the patient became tachycardiac with abdominal distension. A CT scan showed the PEG tube traversing through the transverse colon.

The patient underwent a laparotomy and repair of colonic injury and made an uneventful recovery.


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