Intestinal and Portal Emphysema After Endoscopic Gastrostomy: A Case Report

Abstract

The patient was an 84-year-old man with pre-existing hypertension, atrial fibrillation, and mitral regurgitation who presented with chest pain. He was diagnosed as having a thoracic aortic aneurysm and treated by emergency thoracic aortic stent graft interpolation (TEVAR). Subsequently, reoperation was scheduled for the residual dissection and mitral regurgitation. Endoscopic gastrostomy (PEG) was performed due to poor oral intake. Tube feeding was started on the following day, and metoclopramide was used as needed for vomiting. On the 11th day after gastrostomy, a contrast-enhanced CT for preoperative evaluation revealed intestinal and portal emphysema, and the patient was referred for surgical consultation. Although the patient did not have fever and there were no abnormal laboratory data or abdominal findings, an exploratory laparotomy was performed considering the patient’s underlying disease, which revealed no intestinal necrosis. We encountered a case of intestinal and portal emphysema as complications secondary to PEG, in which the surgery proved overly invasive.