PEG Site Perforation: A Case Report | Cureus

A 75-year-old patient experienced a colon perforation one day after undergoing a percutaneous endoscopic gastrostomy (PEG) procedure, according to a case study published in Endoskopie heute.

The perforation occurred during a PEG implantation utilizing the OTSC-system. Following the procedure, the patient presented with hemoglobin-relevant peranal hemorrhage. A subsequent colonoscopy revealed the complication.

PEG is a minimally invasive procedure used to provide long-term access to the stomach for nutrition or medication when a patient is unable to capture food by mouth. Radiopaedia details instances where the PEG tube can perforate the colon, specifically noting a case where a thin portion of the transverse colon was interposed between the gastric and anterior abdominal wall.

Complication management following PEG implantation can be complex. Researchers Fähndrich, Sandmann, and Heike, of the Medical Center – Gastroenterology and Interventional Endoscopy, Klinikum Dortmund, Germany, detailed their successful management of this particular colon perforation in their published case study.

In separate cases, inadvertent early removal of a PEG tube can also lead to complications, including gastric perforation, requiring immediate attention. A study published in J Community Hosp Intern Med Perspect details an approach termed ‘re-PEGing’ – a semi-urgent endoscopic replacement of the tube – used in seven patients with favorable results.

Another case, documented by ScienceDirect, involved a PEG tube protruding into the jejunal lumen 20 cm distal to a duodenojejunal anastomosis.