2019 Volume 94 Issue 1 Pages 45-48
The patient was a 73-year-old man with amyotrophic lateral sclerosis (ALS) and dysphagia. A percutaneous endoscopic gastrostomy (PEG) tube was placed according to the introducer modification technique without difficulty. Six months later, as the PEG tube was being exchanged, a colocutaneous fistula was discovered by radioscopy and abdominal CT. The gastrostomy tube was able to be exchanged with using a guide wire and a Pean forcep through the fistula and fixing the gastric wall to the abdominal wall. The patient experienced no complications and was discharged after two days. In cases of colocutaneous fistula without emergency laparotomy, PEG tube exchange can still be performed safely if an appropriate protocol is in place.
