Two cases of percutaneous endoscopic gastrostomy assisted by colonoscopy

Abstract

Percutaneous endoscopic gastrostomy (PEG) is a safe and easy method of providing enteral nutrition. However, there are some reports of complications including accidental colon puncture. We report two cases where the transverse colon interfered with the puncture route but we were able to perform PEG safely via colonoscopy. In both cases, preoperative CT identified the transverse colon intervening between the stomach and the abdominal wall. We inserted a colonoscope under fluoroscopy, and pulled the transverse colon downwards in order to successfully place a PEG. Preoperative CT examinations can offer valuable information about abdominal organs and are useful to prevent unexpected complications. PEG assisted by colonoscopy is a safe and effective procedure that may be used when the transverse colon intervenes between stomach and abdominal wall.