Endoscopic Closure of a Gastric Perforation Developing as a Complication after Percutaneous Endoscopic Gastrostomy Insertion / 대한내과학회지

ABSTRACT

Percutaneous endoscopic gastrostomy (PEG) is a relative safe but invasive procedure associated with both minor and major complications. Gastric perforation is one of the major complications, usually requiring surgical intervention. As most patients undergoing PEG have severe, chronic underlying diseases and are in a poor general condition, surgical intervention may substantially increase the risk of subsequent complications. A 75-year-old female suffering from an advanced glioblastoma underwent PEG to allow enteral nutrition in a local hospital. Four days later, she presented with fever and confusion. Three days after that, she presented with a generalized tonic-clonic seizure and was referred to the Asan Medical Center emergency room. Diagnostic work-up revealed PEG tube dislocation and a gastric wall defect. Therefore, the PEG tube was removed and endoscopic primary closure was performed using a detachable snare, hemoclips, and fibrin glue. Three weeks after closure, fluoroscopy revealed no leakage and the patient resumed enteral feeding without any complication.