title: Recurrent tense pneumoperitoneum due to air influx via abdominal wall stoma of a PEG tube.
abstract: A 70 years old male on ventilatory and circulatory support for sepsis and non ST segment elevation myocardial infarction developed abdominal distension 14 d after placement of a percutaneous endoscopic gastrostomy tube for enteral feeding. Radiography revealed free air in the abdomen and gastrograffin (G) study showed no extravasation into the peritoneum. The G tube was successfully repositioned with mechanical release of air. Imaging showed complete elimination of free air but the patient had a recurrence of pneumoperitoneum. Mechanical release of air with sealing of the abdominal wound was performed. Later, the patient was restarted on tube feeding with no complications. This case demonstrates a late complication of pneumoperitoneum with air leakage from the abdominal wall stoma.
authors.affiliation: Rajakrishnan Vijayakrishnan, Deep Adhikari, Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States.
authors.forename: Rajakrishnan
authors.initials: R
authors.lastname: Vijayakrishnan
authors.forename: Deep
authors.initials: D
authors.lastname: Adhikari
authors.forename: Curuchi P
authors.initials: CP
authors.lastname: Anand