Acute pancreatitis and cholangitis

Oct 25 2007

Percutaneous endoscopic gastrostomy (PEG) is generally considered to be safe with a low rate of serious complications.

However, dislocation of a gastrostomy tube can lead to serious complications.

The case report article describes a patient who presented to Dr. Imamura of Aichi Medical University Hospital. It was published on October 21 in the World Journal of Gastroenterology.

An 86-year-old woman with gastrostomy tube feeding sometimes vomited and complained of abdominal tenderness after her family doctor replaced the tube. Imaging studies showed the tip of the gastrostomy tube with the balloon had migrated into the second portion of the duodenum. They diagnosed acute pancreatitis and cholangitis secondary to duodenal obstruction. Her family doctor might have inserted the tube too deeply. After the tube was replaced, her symptoms improved immediately.

Five cases of acute pancreatitis related to gastrostomy tube migration have been reported. Dr. Imamura experienced a very rare complication of gastrostomy tube, and this case demonstrated that a malpositioned gastrostomy tube can be an iatrogenic cause of acute pancreatitis and cholangitis.