Gastroenteric fistula complicating percutaneous endoscopic gastrostomy.
BACKGROUND
Gastroenteric fistula occurs in 2% to 3% of patients undergoing percutaneous endoscopic gastrostomy (PEG). The authors identified 12 children with this major complication.


METHODS
A retrospective case note review was performed.


RESULTS
Over a 5-year period, the complication rate for gastroenteric fistula was 3.5% (12 of 343 procedures). Presentation ranged from 1 day to 25 months post-PEG insertion. Eight patients presented with acute intestinal obstruction. The gastroenteric fistulous tract involved the posterior wall of the stomach in all cases. The plain abdominal x-ray was useful in establishing the diagnosis of the gastroenteric fistula.


CONCLUSIONS
Patients with gastroenteric fistula as a complication of PEG insertion can remain asymptomatic for prolonged periods. It often is difficult to make the diagnosis. A plain abdominal x-ray is a useful diagnostic modality.
Patwardhan
Nitin
N
Department of Paediatric Surgery, Great Ormond Street Hospital NHS Trust, London, England, UK.
McHugh
Kieran
K
Drake
David
D
Spitz
Lewis
L
D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D005183:Failure to Thrive / Q000209:etiology / Q000628:therapy; D005260:Female; D005747:Gastric Fistula / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D005773:Gastroscopy; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies