PERITONITIS COMPLICATION AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) A CASE REPORT AND LITERATURE REVIEW
Main Article Content
Abstract
Percutaneous endoscopic gastrostomy (PEG) is a common procedure for enteral nutrition in patients with dysphagia. Although generally safe, PEG can lead to complications, including peritonitis. We present a clinical case of peritonitis following PEG placement to emphasize the importance of early recognition and timely management. Case study: A 72-year-old female patient with a history of pneumonia, Parkinson’s disease, and post-stroke sequelae with dysphagia underwent PEG placement for nutritional support. Four days post-procedure, she developed abdominal distension, fever, and purulent discharge from the PEG site. Laboratory tests showed elevated white blood cell count and inflammatory markers. Abdominal CT imaging revealed free air in the peritoneal cavity, raising suspicion of peritonitis. The patient was treated with broad-spectrum antibiotics and underwent emergency surgery. Intraoperatively, gastric content leakage into the peritoneal cavity was detected. The abdominal cavity was irrigated, and the leakage site was repaired, leading to successful recovery. Discussion: Peritonitis following PEG placement is a rare but serious complication, often resulting from early tube dislodgment, improper positioning, or gastric content leakage. Risk factors include advanced age, malnutrition, and underlying medical conditions. Early diagnosis based on clinical symptoms and imaging is crucial. Treatment may involve conservative management with antibiotics in mild cases, but surgical intervention is required in severe peritonitis cases. Conclusion: This case highlights the importance of close monitoring after PEG placement, early recognition of complications, and a multidisciplinary approach to optimize patient outcomes. Clinicians should remain vigilant for peritonitis in patients presenting with acute abdominal symptoms after PEG placement.
Article Details
Keywords
percutaneous endoscopic gastrostomy, peritonitis, complications, enteral nutrition
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