Unsuccessful Practice of Percutaneous Endoscopic Gastrostomy in an Infant with Gastric Volvulus: a Case Report

Öz

Percutaneous endoscopic gastrostomy (PEG) is an easy and safe procedure for long-term enteral feeding in children with inadequate oral intake. Although PEG has been used for treatment of gastric volvulus in adults, there is a little relevant data for its use in children. Here, we report a 17-month-old male infant who was admitted to our hospital with a 1-month history of vomiting. Upper gastrointestinal contrast study revealed an organoaxial gastric volvulus. Then PEG was inserted for the purpose of nutritional support. Because the patient continued to vomit after feeding via gastrostomy, surgery was planned. Laparotomy revealed that the entry of the PEG tube was at the posterior wall of the stomach. The gastrostomy tube was removed, and the opening was repaired. Then the stomach was repositioned, and Nissen fundoplication and a Stamm gastrostomy at the anterior wall of the stomach were performed. The patient had no further episodes of vomiting after surgery and was discharged following an uneventful recovery period

Anahtar Kelimeler

• Children,gastric volvulus,percutaneous endoscopic gastrostomy,complication

Unsuccessful Practice of Percutaneous Endoscopic Gastrostomy in an Infant with Gastric Volvulus: a Case Report

Abstract

Percutaneous endoscopic gastrostomy (PEG) is an easy and safe procedure for long-term enteral feeding in children with inadequate oral intake. Although PEG has been used for treatment of gastric volvulus in adults, there is a little relevant data for its use in children. Here, we report a 17-month-old male infant who was admitted to our hospital with a 1-month history of vomiting. Upper gastrointestinal contrast study revealed an organoaxial gastric volvulus. Then PEG was inserted for the purpose of nutritional support. Because the patient continued to vomit after feeding via gastrostomy, surgery was planned. Laparotomy revealed that the entry of the PEG tube was at the posterior wall of the stomach. The gastrostomy tube was removed, and the opening was repaired. Then the stomach was repositioned, and Nissen fundoplication and a Stamm gastrostomy at the anterior wall of the stomach were performed. The patient had no further episodes of vomiting after surgery and was discharged following an uneventful recovery period

Keywords

• Children,gastric volvulus,percutaneous endoscopic gastrostomy,complication

References

1. 1. Tanner NC. Chronic and recurrent volvulus of the stomach. Am J Surg 1968;115:105-9. [CrossRef]
2. 2. Gauderer MW, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980;15:872-5. [CrossRef]
3. 3. Gauderer MW. Percutaneous endoscopic gastrostomy-20 years later: a historical perspective. J Pediatr Surg 2001;36:217-9. [CrossRef]
4. 4. Yu SC, Petty JK, Bensard DD, Partrick DA, Bruny JL, Hendrickson RJ. Laparoscopic-assisted percutaneous endoscopic gastrostomy in children and adolescents. JSLS 2005;9:302-4.
5. 5. Eckhauser ML, Ferron JP. The use of dual percutaneous endoscopic gastrostomy (DPEG) in the management of chronic intermittent gastric volvulus. Gastrointest Endosc 1985;31:340-2. [CrossRef]
6. 6. Behrens R, Lang T, Muschweck H, Richter T, Hofbeck M. Percutaneous endoscopic gastrostomy in children and adolescents. J Pediatr Gastroenterol Nutr 1997;25:487-91. [CrossRef]
7. 7. Patwardhan N, McHugh K, Drake D, Spitz L. Gastroenteric fistula complicating percutaneous endoscopic gastrostomy. J Pediatr Surg 2004;39:561-4. [CrossRef]
8. 8. Croaker GDH, Najmaldin AS. Laparoscopically assisted percutaneous endoscopic gastrostomy. Pediatr Surg Int 1997;12:130-1. [CrossRef]

9. 9. Grunow JE, al-Hafidh A, Tunell WP. Gastroesophageal reflux following percutaneous endoscopic gastrostomy in children. J Pediatr Surg 1989;24:42-5. [CrossRef]
10. 10. Razeghi S, Lang T, Behrens R. Influence of percutaneous endoscopic gastrostomy on gastroesophageal reflux: a prospective study in 68 children. J Pediatr Gastroenterol Nutr 2002;35:27-30. [CrossRef]
11. 11. Ponsky JL, Aszodi A. Percutaneous endoscopic jejunostomy. Am J Gastroenterol 1984;79:113-6. [CrossRef]
12. 12. Jolley SG, Tunell WP, Hoelzer DJ, Thomas S, Smith EI. Lower esophageal pressure changes with tube gastrostomy: a causative factor of gastroesophageal reflux in children? J Pediatr Surg 1986;21:624-7. [CrossRef]