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Case Reports
. 2025 Sep 17;12(9):e01834.
doi: 10.14309/crj.0000000000001834. eCollection 2025 Sep.

Unusual Complication of Percutaneous Gastrostomy Tube Replacement

Si Ru Liang  1 , Gyanprakash Ketwaroo  1   2 , Basile Njei  1 , Amy Ogurick  1   2 , Anahita Rabiee  1   2 , Petr Protiva  1   2
Affiliations
Case Reports

Unusual Complication of Percutaneous Gastrostomy Tube Replacement

Si Ru Liang et al. ACG Case Rep J. .

Abstract

Percutaneous endoscopic gastrostomy tubes are commonly used for long-term nutritional support in patients with impaired swallowing due to neurological conditions, malignancy, or critical illness. Although placement, removal, and replacement are generally safe, complications may occur. We report a case of complete gastric outlet obstruction due to unusually deep percutaneous endoscopic gastrostomy tube insertion during replacement in a 63-year-old man with esophageal cancer. Symptoms resolved after repositioning the tube. This case highlights the need for proper training and postreplacement verification to ensure safe outcomes.

Keywords: PEG; gastric outlet obstruction; percutaneous gastrostomy tube.

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Figures

Figure 1.
Figure 1.
Computer tomography images of the case. (A) Axial section demonstrating a very distended stomach with the PEG tube entering the stomach body (arrows); (B) coronal section showing the same finding of a distended stomach with the PEG tube appearing in the distal stomach (arrow); (C and D) axial and coronal sections showing the PEG tube balloon inflated in the pyloric channel/duodenum, causing a gastric outlet obstruction. PEG, percutaneous endoscopic gastrostomy.
See this image and copyright information in PMC

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