ABSTRACT
Resumen La pancreatitis aguda secundaria a la obstrucción de la papila mayor causada por la migración del balón interno es uno de los efectos secundarios poco frecuentes, pero potencialmente graves relacionados con el uso de gastrostomías endoscópicas percutáneas (PEG). Hasta ahora solo existen 15 casos reportados en el mundo, presentamos el que para nuestro conocimiento sería el caso número 16 en la literatura internacional.
Abstract Acute pancreatitis secondary to major papilla obstruction caused by intragastric balloon migration is one of the rare but potentially severe side effects associated with the use of percutaneous endoscopic gastrostomy (PEG). To date, there are only 15 cases reported worldwide. This article presents a case that, to the best of our knowledge, is the sixteenth case reported in the international literature.
Subject(s)
Humans , Male , Female , Pancreatitis , Gastrostomy , LiteratureABSTRACT
Percutaneous Endoscopic Gastrostomy (PEG) tubes were often offered to patients requiring long term enteral feeding. Even though the procedure is relatively safe, it is associated with various complications such as peritonitis or even death. 1 We presented a case of a 54-year-old gentleman with underlying ischemic stroke and pus discharges from a recently inserted PEG tube. Computed Topography (CT) scan confirmed abdominal wall necrotising fasciitis complicated with hyperosmolar hyperglycaemia state (HHS) and later succumbed after 48 hours of admission. Our case illustrated the rare complication related to the insertion of PEG tube; abdominal wall necrotising fasciitis that was associated with mortality.
Subject(s)
GastrostomyABSTRACT
We administered daikenchuto to the patients having recurrent aspiration pneumonia with tube feeding, who had good responses. Case 1 : A 94-year-old-man with congestive heart failure suffering from recurrent aspiration pneumonia even after percutaneous endoscopic gastrostomy (PEG) placement : following daikenchuto administration, he did not suffer from pneumonia, and his general condition became stable. Case 2 : An 80-year-old-man suffering from severe pneumonia after PEG placement, and experiencing recurrent pneumonias after treatment with antibiotics:following daikenchuto administration, we did not find gastric contents in his oral cavity as before, and his general condition became stable. Case 3 : An 85-year-old-man with congestive heart failure and cerebral infarction also suffering from aspiration pneumonia : a nasogastric tube was placed, but he suffered from recurring pneumonias with tube feeding. After administering daikenchuto, he did not suffer from pneumonia and was discharged from the hospital. Case 4 : An 81-year-old-man with recurrent pneumonia and congestive heart failure : after treatment with antibiotics, we placed a PEG tube because of his severe anorexia caused by oral feeding difficulties. In order to prevent aspiration pneumonia, we administered daikenchuto prophylactically. He subsequently developed very little fever until his discharge to a nursing home.
ABSTRACT
BACKGROUND/AIMS: Percutaneous endoscopic gastrostomy (PEG) has been widely used for long term enteral nutrition. The most common complication is peristomal wound infection. The aim of this study is to investigate the risk factors for peristomal wound infection after PEG. METHODS: We reviewed the records of 55 patients who had undergone PEG placement at Kangnam St. Mary's hospital via the Pull-string technique. We analyzed the underlying disease, the performance status and the nutritional state of the patients to determine the risk factors for wound infection. RESULTS: Peristomal wound infection after PEG occurred in 20 (36.4%) of the 55 patients. Methicillin resistant Staphylococcus aureus (MRSA) was the most common isolated microorganism. On univariate analysis, the underlying CNS disease, non-malignant disease and a decreased performance status (ECOG 3, 4) were correlated with wound infection. On multivariate analysis, a decreased performance status was an independent risk factor for wound infection after PEG (p=0.007, OR=6.011, CI: 1.64~22.09). CONCLUSIONS: A decreased performance status was an independent risk factor for peristomal wound infection after PEG.
Subject(s)
Humans , Central Nervous System Diseases , Enteral Nutrition , Gastrostomy , Methicillin Resistance , Multivariate Analysis , Risk Factors , Staphylococcus aureus , Wound Infection , Wounds and InjuriesABSTRACT
OBJECTIVE: The purposes of this study are to estimate the proper replacement time of percutaneous endoscopic gastrostomy Foley catheter for prevention of accidental expulsion from the stomach, and to identify factors influencing deflation of balloon. METHOD: Silicone Foley catheters (22 Fr) were placed and compared in the different environments: 1) different acidity (pH 1, 2, 3, 4, 7), 2) static versus dynamic (100 RPM) environment. The balloon capacity of 30 ml versus 5 ml inflated with 5 ml of normal saline were compared. Mean time interval of deflation of balloon down to the capacity of 2.5 ml and 1 ml was estimated and compared respectively. RESULTS: The results showed no significant difference of the decrease of the balloon of the Foley catheters in each acidity except for pH 1 and dynamic environment. But capacity of balloon could affect deflation. The mean days of deflation of total Foley catheter down to 2.5 ml and 1 ml were 23.5+/-5.3 and 42.2+/-7.2 days respectively. CONCLUSION: Physiological gastric acidity and dynamic environment did not affect the deflation of the Foley catheter significantly, but the capacity of the balloon affected it. And suggested proper time of the replacement of the Foley catheter gastrostomy tube is ranged from 24 to 42 days after exchange.