2017 Volume 59 Issue 3 Pages 272-276
A 76-year-old woman with dysphagia due to progression of amyotrophic lateral sclerosis underwent percutaneous endoscopic gastrostomy (PEG). On postoperative day 2, the patient felt abdominal fullness. Radiography revealed an enlarged region from the small intestine to the transverse colon. Following the diagnosis of ileus, the stomach wall, which had been fixed for gastropexy during the PEG procedure, was unfixed, and her symptoms improved quickly. We believe that the site of paracentesis in this case may have been lower than usual and that the transverse colon was penetrated at the lower of the two wall-fixing points, resulting in ileus. Although preoperative upper gastrointestinal tract endoscopy and abdominal CT scanning are important for determining the appropriate site of paracentesis, adequate consideration should be given to confirm standard paracentesis positions at the time of the procedure.
