A case is presented of migration of a gastrostomy feeding tube (Foley type) through the pylorus with duodenal obstruction and subsequent retrograde intussusception. Although feeding tube migration is not uncommon, retrograde intussusception of the jejunum into the duodenum is rare. In this case, surgery was required with resection of a segment of necrotic bowel. Recommendations are given for treatment of this unusual complication with emphasis on its avoidance through use of a retaining bar or disc at the tube's skin exit site.
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References
1.
Gauderer MWL , Ponsky JL, Izant RJ Jr.Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg1980;15:872-5.
2.
Haws EB, Sieber WK, Kiesewetter WBComplications oftube gastrostomy in infants and children: 15 year review of 240 cases. Ann Surg1966;164:284-90.
3.
Avinoah E., Peiser J., Ovnat A., et al. Gastrostomy-induced duodenal obstruction after gastric bypass . Br J Surg1988;75:492.
Walsh MJ, Clement DJReplacement gastrostomy tube as a cause of gastric outlet obstruction . Gastrointest Endosc1990;36:640.
6.
Pereira MC, Mersich K.Foley catheter gastrostomy tube migration: small bowel obstruction relieved by percutaneous balloon aspiration. Gastrointest Endosc1991;37:372-4.
7.
McGovern R., Barkin JS, Goldberg RI, et al. Duodenal obstruction: a complication of percutaneous endoscopic gastrostomy tube migration. Am J Gastroenterol1990;85:1037-8.
8.
Hopens T., Schwesinger WHComplications of tube gastrostomy: radiologic manifestations. South Med J1983;76:9-11.
9.
Oswald MP, Graviss ER, Danis RK, et al. Duodenogastric intussusception causing gastric outlet obstruction . J Pediatr Surg1982;17:82-3.
Dubinsky TJ , Kang K.CT appearance of retrograde jejunoduodenogastric intussusception: a rare complication of gastrostomy tubes. AJR1992;158:212-3.
12.
Weber A., Nadel S.CT appearance ofretrograde jejunoduodenogastric intussusception: a rare complication of gastrostomy tubes. AJR1991;156:957-9.
13.
Osborne RO, Toffler RBGastrostomy tube prolapse. Am J Gastroenterol1973;60:602-6.
14.
Vade A., Jafvi SZH, Agha FP, et al. Radiologic evaluation of gastrostomy complications. AJR1983;141:325-30.
15.
Konda J., Ruggle P.Prolapse of Foley catheter gastrostomy tube causing obstructive jaundice . Am J Gastroenterol1981;76:353-5.
16.
Tom W., Zachary K., Fruchter G., et al. Case report: prolapse of gastrostomy tube resulting in entero-enteric fistula and intussusception. Am Surg1988;54:245-7.
17.
Fischer LS, Bonello JC, Greenberg E.Gastrostomy tube migration and gastric outlet obstruction following percutaneous endoscopic gastrostomy. Gastrointest Endosc1987; 33:381-2.