Abdominal wall necrotizing fasciitis from dislodged percutaneous endoscopic gastrostomy tubes: a case series.
We report three cases of abdominal wall necrotizing fasciitis that occurred as a result of leakage from displaced percutaneous endoscopic gastrostomy tubes. This is the first report of such a series. Patients underwent extensive operative excisions of their abdominal walls down to their posterior fascia. All patients tolerated their initial surgery, however, two patients ultimately expired from respiratory complications. The surviving patient underwent multiple repeat debridements and reconstructive abdominal wall surgery. We review the epidemiology of patients at risk for this complication and discuss its presentation, as well as the appropriate workup and management. We also address the issues of closure of large abdominal wall defects and future alimentation in this patient group. Finally, abdominal wall necrotizing faciitis from gastrostomy tube leakage is a devastating complication, and the development of preventative strategies for patients at risk is of paramount importance.
MacLean
Alexandra A
AA
Trauma Service, Bellevue Hospital Center, New York University School of Medicine, New York, New York, USA.
Miller
George
G
Bamboat
Zubin M
ZM
Hiotis
Karen
K
D034861:Abdominal Wall; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D004750:Enteral Nutrition / Q000009:adverse effects*; D019115:Fasciitis, Necrotizing / Q000209:etiology* / Q000628:therapy*; D017809:Fatal Outcome; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents