Pyeloduodenal fistula: a previously undescribed complication of Stamm gastrostomy.
A variety of complications have been described after placement of a Stamm gastrostomy in infants and children, including gastric volvulus, pancreatitis, jaundice, gastroduodenal mucosal intussusception with gastric outlet obstruction, and even aortogastric fistula. However, this is the first report of pyeloduodenal fistula after Stamm gastrostomy in a 4 1/2-month-old boy. The child successfully underwent nonoperative therapy; he was treated by withdrawing the gastrostomy tube (Foley catheter) from the renal pelvis, bowel rest, and total parenteral nutrition. After the case presentation is a brief review of this rare entity, with its clinical presentation and pathophysiological differences between adult and pediatric cases. Various treatment options, both operative and nonoperative, are also described.
Bleacher
J C
JC
Department of Surgery, Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey 17033.
Boline
G B
GB
Decter
R M
RM
Conter
R L
RL
D004378:Duodenal Diseases / Q000453:epidemiology / Q000209:etiology*; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007412:Intestinal Fistula / Q000453:epidemiology / Q000209:etiology*; D007441:Intubation, Gastrointestinal / Q000009:adverse effects*; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology*; D007682:Kidney Pelvis; D008297:Male; D014548:Urinary Fistula / Q000453:epidemiology / Q000209:etiology*