Profuse diarrhea after percutaneous change of a computed tomography-guided gastrostomy: endoscopic closure of a colocutaneous fistula
Amani Al Khatib, Anaïs Bertrand, Henri Duboc, Olivier Bonsack, Benoit Coffin, Heithem Soliman
Abstract
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TopicsClinical Nutrition and Gastroenterology · Abdominal Surgery and Complications · Child Nutrition and Feeding Issues
A 71-year-old patient was admitted after the accidental dislodgement of a computed tomography (CT)-guided percutaneous gastrostomy, placed 1 year prior. The initial procedure was uneventful and facilitated rapid weight gain. A percutaneous MIC-KEY tube (Avanos, Alpharetta, Georgia, USA) was rapidly placed along the previous route. As soon as nutrition was restarted, “on and off” profuse diarrhea occurred, ceasing as the nutrition was stopped and resuming immediately upon resumption. Opacification of the MIC-KEY tube revealed a fistulous tract between the transverse colon and the skin ( Video 1 ). Conservative treatment was decided, involving the endoscopic closure of the residual colocutaneous fistula, achieved by placing an Ovesco clip (Ovesco Endoscopy, Tübingen, Germany) during a colonoscopy 1 .
In conclusion, a transcolonic perforation may go unnoticed during the months 2 after a CT-guided percutaneous gastrostomy. Colocutaneous fistulous tract can be safely closed using an Ovesco clip during a colonoscopy 1 3 , to avoid the need for surgery.
Endoscopy_UCTN_Code_TTT_1AO_2AK
The reference list from the paper itself. Each links out to its DOI / PubMed record.
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- 2Van Gossum A Des Marez B Cremer MA colo-cutaneous-gastric fistula: a silent and unusual complication of percutaneous endoscopic gastrostomy Endoscopy 19882016110.1055/s-2007-10181663181089 · doi ↗ · pubmed ↗
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