[Intercostal percutaneous ultrasound guided decompressive gastrostomy (PUG)--a case report].
Percutaneous gastrostomies (PG) are nowadays usually placed endoscopically (PEG). Due to stenoses in the pharynx or the esophagus or in case of a lack of diaphany, other methods for the placement of PG such as computed tomography (CT-) guided or ultrasound-guided PG (PUG) are performed. We present a case of a 63-year old male patient with a retroperitoneal liposarcoma and multivisceral resection who presented with the symptoms and signs of an ileus due to metastatic occlusion of the small bowel. The placement of a decompression-PEG was impossible due to interposition of colon between the stomach and the abdominal wall. After filling the stomach with water via a naso-gastral decompression tube, the stomach could be visualized at the left thoracic wall, since the spleen and the left kidney had been removed at prior surgery. A transcostal decompression-PUG was inserted. The intervention described is the first published ultrasound guided transcostal decompression gastrostomy and is an example for the growing significance of interventional ultrasound.
Schlottmann
K
K
Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg. klaus.schlottmann@klinik.uni-regensburg.de
Gelbmann
C
C
Schölmerich
J
J
Lock
G
G
D002408:Catheters, Indwelling; D019299:Decompression, Surgical; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery; D005774:Gastrostomy; D006801:Humans; D008080:Liposarcoma / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D013909:Thorax; D014463:Ultrasonography