Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Management of Percutaneous Endoscopic Gastrostomy Site Gastric Ulcer in a Patient with an Esophageal Stricture and Hiatus Hernia

  • Wu, Clement CH (Department of Gastroenterology and Hepatology, Changi General Hospital) ;
  • Li, James W (Department of Gastroenterology and Hepatology, Changi General Hospital) ;
  • Ng, Keng Sin (Department of Diagnostic Radiology, Changi General Hospital) ;
  • Ang, Daphne S (Department of Gastroenterology and Hepatology, Changi General Hospital)
  • Received : 2017.03.04
  • Accepted : 2017.04.26
  • Published : 2018.01.30
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Abstract

Percutaneous endoscopic gastrostomy (PEG) is commonly performed for feeding difficulties, in patients suffering from complications of nasopharyngeal carcinoma (NPC) and its treatment, namely radiotherapy and surgery. This case report describes the challenges in hemostasis and subsequent re-establishment of enteral access for feeding, in an elderly patient with a history of NPC, treated surgically, followed by radiotherapy, who presented with massive hematemesis following reinsertion of her PEG shortly after an accidental dislodgement. Her previous nasopharyngectomy, wide field radiation therapy, and radical neck dissection precluded nasogastric tube feeding, and the presence of a large hiatus hernia made reinsertion of a new PEG technically challenging. This case highlights the methods used to overcome the above challenges.

Keywords

References

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