Case Report
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2007; 13(39): 5285-5287
Published online Oct 21, 2007. doi: 10.3748/wjg.v13.i39.5285
Acute pancreatitis and cholangitis: A complication caused by a migrated gastrostomy tube
Hiroshi Imamura, Toshihiro Konagaya, Takashi Hashimoto, Kunio Kasugai
Hiroshi Imamura, Toshihiro Konagaya, Takashi Hashimoto, Kunio Kasugai, Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 21, Karimata, Yazako, Nagakute-cho, Aichi-gun, Aichi-ken, 480-1195, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Hiroshi Imamura, Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 21, Karimata, Yazako, Nagakute-cho, Aichi-gun, Aichi-ken, 480-1195, Japan. imamurah@aichi-med-u.ac.jp
Telephone: +81-561-623311 Fax: +81-561-621508
Received: June 19, 2007
Revised: August 8, 2007
Accepted: September 12, 2007
Published online: October 21, 2007
Abstract

Percutaneous endoscopic gastrostomy (PEG) is generally considered safe with a low rate of serious complications. However, dislocation of the PEG-tube into the duodenum can lead to serious complications. An 86-year old Japanese woman with PEG-tube feeding sometimes vomited after her family doctor replaced the PEG-tube without radiologic confirmation. At her hospitalization, she complained of severe tenderness at the epigastric region and the PEG-tube was drawn into the stomach. Imaging studies showed that the tip of PEG-tube with the inflated balloon was migrated into the second portion of the duodenum, suggesting that it might have obstructed the bile and pancreatic ducts, inducing cholangitis and pancreatitis. After the PEG-tube was replaced at the appropriate position, vomiting and abdominal tenderness improved dramatically and laboratory studies became normal immediately. Our case suggests that it is important to secure PEG-tube at the level of skin, especially after replacement.

Keywords: Percutaneous endoscopic gastrostomy; Complications; Tube migration; Pancreatitis; Cholangitis