Laparoscopic Salvage of Percutaneous Endoscopic Gastrostomy Tract Dehiscence Following Blind Reinsertion: A Case Report
- Author:
Jia Chyi Tay
1
;
Guhan Muthkumaran
1
;
Hans Alexander Mahendran
2
;
Woon Teen Sia
3
;
Sekkapan Thannimalai Sambanthan
2
;
Jia Chyi Tay
2
Author Information
- Publication Type:Journal Article
- Keywords: Breast; hypercalcaemia; malignant phyllodes; paraneoplastic syndrome; thrombosis
- From: Journal of Surgical Academia 2025;15(2):41-44
- CountryMalaysia
- Language:English
- Abstract: Laparoscopic Salvage of Percutaneous Endoscopic Gastrostomy Tract Dehiscence Following Blind Reinsertion: A Case Report:Percutaneous endoscopic gastrostomy (PEG) is a commonly performed and generally safe method for long-term enteral nutrition. Nevertheless, accidental dislodgement is a well-recognised complication, and premature or unguided reinsertion may result in severe morbidity. We described a 60-year-old man with a history of cerebrovascular accident who developed peritonitis following blind reinsertion of a dislodged PEG tube. Diagnostic laparoscopy revealed partial tract dehiscence and intraperitoneal contamination, necessitating laparoscopic refashioning and peritoneal lavage. His postoperative course was complicated by recurrent dislodgement and stomal stenosis, successfully managed with endoscopic reinsertion under direct visualisation. Blind reinsertion of PEG tubes carries significant risk even in apparently mature tracts. Laparoscopy provides both diagnostic confirmation and therapeutic control in cases of tract dehiscence or peritonitis. Image-guided or endoscopic techniques should be prioritised to minimise recurrence and ensure safe re-establishment of enteral access. Early recognition and image-guided management are essential to prevent peritonitis and preserve long-term enteral access. Laparoscopy remains the preferred modality for both diagnosis and salvage in complex PEG-related complications.
- Full text:2026072918150694747Laparoscopic.pdf
