OJGas  Vol.3 No.2 , May 2013
Transhepatic percutaneous endoscopic gastrostomy
ABSTRACT

We describe the case of a hepatic injury after the insertion of a PEG. In a cirrhotic woman affected by a locally advanced cancer of the pharynx, the PEG tube was inserted through the edge of the left lobe of the liver. The patient was treated with a conservative approach by managing abdominal pain and the PEG was removed after 4 months without complication. Hepatic injury is a rare complication of PEG placement; in order to avoid it, PEG tube should be inserted to the left of the abdominal midline and the lower edge of the liver should be defined by palpation; in cirrhotic patients, where left hepatic lobe hyper-trophy is common, ultrasound guidance could have been appropriate.


Cite this paper
Poggi, G. , Montagna, B. and Cesare, P. (2013) Transhepatic percutaneous endoscopic gastrostomy. Open Journal of Gastroenterology, 3, 87-88. doi: 10.4236/ojgas.2013.32014.
References
[1]   Schrag, S.P., Sharma, R., Jaik, N.P., et al. (2007) Complications related to percutaneous endoscopic gastrostomy (PEG) tubes. A comprehensive clinical review. Journal of Gastrointestinal and Liver Diseases, 16, 407-418.

[2]   Burke, D.T. and Geller, A.I. (2009) Peritonitis secondary to the migration of a transhepatically-placed percutaneous endoscopic gastrostomy tube: A case report. Archives of Physical Medicine and Rehabilitation, 90, 354-357. doi:10.1016/j.apmr.2008.06.038

[3]   Gubler, C., Wildi, S.M. and Bauerfeind, P. (2005) Liver injury during PEG tube placement: Report of two cases. Gastrointestinal Endoscopy, 61, 346-348. doi:10.1016/S0016-5107(04)02584-2

 
 
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