A CASE OF GUIDEWIRE KNOT FORMATION WHILE REPLACING THE GASTROSTOMY TUBE

Abstract

A 100-year-old woman underwent percutaneous endoscopic gastrostomy for swallowing dysfunction. As the gastrostomy tube was replaced without endoscopy or fluoroscopy for the second time, the guidewire could not be removed. After checking the inside of the stomach with endoscopy, a guidewire knot involving the gastric mucosa was formed, loosened endoscopically with biopsy forceps, and removed. Knot formation must be considered if the guidewire cannot be removed while replacing the gastrostomy tube without endoscopy. Moreover, to avoid knot formation, the guidewire should not be inserted too far into the lumen, and some air should be injected into the stomach preoperatively.