2009 Volume 29 Issue 6 Pages 937-939
A 83-year-old bedridden female who had had abdominal pain for 4 days was brought to our hospital by ambulance in October 2008. She had undergone a percutaneous endoscopic gastrostomy (PEG) in August 2006 because of aspiration pneumonia. Six months after the PEG (in February 2007), the PEG catheter was removed to allow adequate oral intake. On arrival at our hospital, the patient's abdomen was distended with tenderness and muscular defense. The laboratory examination revealed elevation of infl ammatory responses. Computed tomography demonstrated a large amount of free air, and a hole in the stomach. On basis of these pieces of evidence, a preoperative diagnosis of gastric perforation was made leading to an urgent laparotomy. A 1cm perforation of the anterior wall was recognized intraoperatively, situated below the skin scar of the PEG. A defi nitive diagnosis was made of gastric perforation at the site where the PEG had been performed, and an omental plug was constructed. The patient's postoperative course was uneventful, and she was discharged from hospital 10 days after the operation.
