Gastrocolocutaneous fistula in a child with congenital short bowel syndrome: a rare complication of percutaneous endoscopic gastrostomy.
Gastrocolocutaneous fistula is a rare major complication of percutaneous endoscopic gastrostomy (PEG). We report a case of this complication in a 2-year-old boy with congenital short bowel syndrome with dilated bowel loops who underwent PEG insertion. Fever developed and stool-like substance was discharged from the gastrostomy tube 1 year later. Further upper gastrointestinal study and panendoscopy revealed a gastrocolonic and colocutaneous fistula. He underwent laparotomy to close the fistula. The recovery was uneventful and he was discharged 10 days after surgery. This case suggests that a previous history of abdominal surgery or dilated bowel loops should be a relative contraindication to PEG procedure. Open surgical gastrostomy is recommended for such patients.
Chen
Yun
Y
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Ni
Yen-Hsuan
YH
Lai
Hong-Shiee
HS
D002675:Child, Preschool; D003108:Colonic Diseases / Q000209:etiology*; D017577:Cutaneous Fistula / Q000209:etiology*; D004750:Enteral Nutrition / Q000009:adverse effects; D005747:Gastric Fistula / Q000209:etiology*; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D012778:Short Bowel Syndrome / Q000601:surgery*