Abdominal Wall Abscess after Prophylactic Percutaneous Endoscopic Gastrostomy Placement in a Patient Undergoing Chemoradiotherapy for Laryngeal Cancer

TL;DR

A patient with laryngeal cancer developed a rare abdominal wall abscess after a routine PEG procedure, requiring drainage due to antibiotic treatment failure.

Contribution

Highlights a rare complication of prophylactic PEG placement and emphasizes the need for early diagnosis to prevent severe outcomes.

Findings

Abdominal wall abscess occurred 12 days after prophylactic PEG placement.

Antibiotics alone were insufficient, requiring drainage for treatment.

Delayed diagnosis risked necrotizing fasciitis, a life-threatening condition.

Abstract

Prophylactic percutaneous endoscopic gastrostomy (PEG) placement for nutritional management prior to chemoradiotherapy is a common procedure in patients with head and neck cancer, for which serious complications are rare. Herein, we present a case of abdominal wall abscess that developed 12 days following prophylactic PEG placement in a patient with laryngeal cancer. This rare complication was initially difficult to diagnose due to subtle abdominal symptoms. In this case, antibiotic treatment alone was inadequate, necessitating drainage tube insertion. This case highlights that delayed diagnosis can lead to necrotizing fasciitis, a potentially fatal condition that should be considered in the differential diagnosis.

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