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Huge submucosal hematoma of the stomach after accidental removal of the PErcutaneous endoscopic gastrostomy tube
Author(s) -
Chikamori Fumio,
Kuniyoshi Nobutoshi,
Kawashima Takahiko,
Takase Yasuhiro
Publication year - 2003
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2003.00267.x
Subject(s) - medicine , percutaneous endoscopic gastrostomy , surgery , aspiration pneumonia , hiatal hernia , hematoma , gastrostomy , pneumonia , general surgery , jejunostomy , parenteral nutrition , peg ratio , disease , finance , reflux , economics
We report a case of massive hemorrhage and aspiration pneumonia as complications of percutaneous endoscopic gastrostomy (PEG). Three months after insertion of a PEG tube, the patient accidentally pulled out the tube by himself. After the accident, the patient experienced hematemesis, which caused aspiration pneumonia. The button‐type tube was reinserted into the PEG fistula for hemostasis. The bleeding stopped temporarily; however, 21 days later, the patient relapsed into a condition of massive PEG site bleeding and hematemesis. He was transferred to our hospital, Kuniyoshi Hospital, to control the bleeding and aspiration pneumonia. Endoscopy revealed a sliding type of large hiatal hernia and a huge submucosal hematoma with an ulceration at the lower part of the gastric body. Emergency surgery including local gastrectomy, gastrostomy, jejunostomy and tracheostomy were helpful to treat these complications. Endoscopists should be aware how to treat these complications. One should not hesitate to perform open surgery when other treatments fail.