A case is an 87-year-old woman post percutaneous endoscopic gastrostomy (PEG). PEG was performed 10 years ago. Gastrostomy tubes had been exchanged every six months, but peristomal leakage and dermatitis around a gastrostomy tube appeared, and she was admitted to our department. Percutaneous Endoscopic Gastrojejunostomy (PEG-J) was performed and leakage decreased, but dermatitis didn't improved. In cooperation with a certified Wound, Ostomy and Continence nurse, we started using cosmetic puff as decompression of a fixation plate, which is superior in hygiene and cost, and dermatitis improved significantly. Not only managing leakage, cosmetic puff also enabled decompression to the skin. Endoscopists should collaborate with multiple professions not only for gastrostomy construction but for various gastrostomy-related problems.
