Percutaneous endoscopic gastrostomy: a dislodgement complication due to a moving hiatal hernia.
Miia L LehtinenIlkka IlonenJuha KauppiJari RäsänenPublished in: Scandinavian journal of gastroenterology (2021)
Objectives: Frail patients with malnourishment due to an esophageal condition and dysphagia are often unamenable to safe surgery. Thus, in high-risk patients, less invasive techniques such as percutaneous endoscopic gastrostomy (PEG) are regarded as a safer choice. Nevertheless, as described here, PEG insertion can have rare serious complications.Materials and methods: We report the case of a frail patient with dysphagia due to a large Zenker's diverticulum and concomitant giant hiatal hernia. To improve her nutrinitional status before surgery she received a PEG after endoscopic repositioning of the hernia.Results: Within 48 hours after hernia repositioning and PEG insertion, a severe adverse event ensued: dislodgement of the PEG due to stomach reherniation.Conclusions: This case challenges the use of PEG as an only means for gastric fixation for hiatal hernia.
Keyphrases
- minimally invasive
- ultrasound guided
- drug delivery
- end stage renal disease
- coronary artery bypass
- chronic kidney disease
- newly diagnosed
- ejection fraction
- emergency department
- gastroesophageal reflux disease
- case report
- prognostic factors
- coronary artery disease
- radiofrequency ablation
- risk factors
- community dwelling
- acute coronary syndrome
- adverse drug