2020 Volume 79 Issue 1 Pages 19-23
In today’s aging society, there are mixed opinions about the indications for gastrostomy. When performing a gastrostomy, the incision should be positioned carefully, bearing in mind the physical structure and anatomical variations of the stomach. Some reports have recommend using bumper-type tubes ,as opposed to balloon-type tubes. Herein, we report a case of duodenal obstruction caused by a percutaneous endoscopic gastrostomy (PEG) tube in an elderly patient. [Case] The patient was an 89-year-old female who had been maintained on enteral nutrition therapy for 2 years. She was suspected as having a bowel obstruction based on her symptoms that lasted for 3 days before her visit, including not being able to pass gas or have a bowel movement, vomiting, and abdominal distention, and she was referred to our department. She had a medical history of dementia, bilateral femoral neck fracture, and dysphagia. With respect to her progress after admission, she was initially bedridden and unable to communicate. In addition, the skin around the gastrostomy site showed redness and erosion, and the imaging findings indicated a duodenal obstruction. After removing and replacing the PEG tube, the obstruction was released, and the gastrointestinal symptoms disappeared. The diagnosis of ball valve syndrome was made. A stomach tumor impacting the duodenal lumen presents a similar clinical state, and thus, attention is necessary.
