Percutaneous placement of gastrostomy was first described in 1980. Since then it has become widely used in pediatric surgery throughout the world. Inherent in the technique is the possibility of inadvertent damage to adjacent anatomical structures, most commonly the transverse colon. Management previously had involved laparotomy and correction of the gastrocolic fistula. Here we describe a nove...

A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inf...

A 67-year-old woman with history of Roux-en-Y gastric bypass presented for management of acute cholangitis. Magnetic resonance cholangiopancreatography (MRCP) demonstrated extrahepatic bile duct dilatation. The results of her liver chemistry tests were aspartate aminotransferase (AST) 156 IU/L, alanine aminotransferase (ALT) 182 IU/L, total bilirubin 2.6mg/dL, and alkaline phosphatase 319IU/L. ...

Despite the lack of clear benefits of feeding via gastrostomy tube in dementia patients, its use has been increasing. The views of health professionals, patients and their carers differ widely about the perceived benefits, which makes decision-making difficult and stressful. The palliative care approach of facilitating better communication and end-of life care planning can help avoid inappropri...

Patients who survive catastrophic brain damage may be left permanently unaware—in the permanent vegetative state. Many doctors are likely to manage these patients at some point in their career. The diagnosis has been the subject of reports prepared by official bodies. It has been defined as “a clinical condition of unawareness of self and environment in which the patient breathes spontaneously,...

Percutaneous endoscopic gastrostomy (PEG) is a well-recognized procedure for providing enteral feeding and long-term enteral nutritional support. Although it is mostly well tolerated, complications, sometimes mechanical in nature, do occur. Rare, and often initially unrecognized, late complications of PEG tube placement are gastric outlet obstruction and duodenal obstruction. Simple adjustment ...

We presented two interesting cases of gastrocolocutaneous fistula that occurred after percutaneous endoscopic gastrostomy (PEG) tube placement, and its management. This fistula is a rare complication that occurs after PEG insertion, which is an epithelial connection between mucosa of the stomach, colon, and skin. The management of the fistula is controversial, ranging from conservative to surgi...

Myasthenia gravis (MG) is an autoimmune disease resulting in destruction of the post-synaptic nicotinic receptors at the neuromuscular junction. Classically, the earliest symptoms of MG are ocular, including ptosis and diplopia. Other less common early symptoms include dysphagia and fatigable chewing. Our case report describes the unusual presentation of MG in a teenager patient and presented f...

angiopancreatography (ERCP) via a gastrostomy by stomal balloon dilation through a surgical or radiological gastrostomy site has been described in a few cases [1–3]. We report here a novel technique for dilating a rigid percutaneous endoscopic gastrostomy (PEG) stoma for therapeutic ERCP. A 69-year-old man with bile duct stones was hospitalized for acute cholangitis. A gastrostomy feeding tube ...

Background: Reflux oesophagitis is an esophageal mucosal injury that occurs secondary to retrograde flux of gastric contents into the esophagus. Here, we reported a case of re-insertion of gastric feeding tube (RIGFT) to an old man who underwent gastrostomy due to progressive Dysphagia secondary to reflux oesophagitis. Methods: We report the case of re-insertion of gastric feeding tube in an el...