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Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure
Patient: Female, 76 Final Diagnosis: Septic shock secondary to liver abscesses and gastro-hepatic fistula from PEG displacement Symptoms: Acute delirium Medication: — Clinical Procedure: None Specialty: Gastroenterology and Hepatology OBJECTIVE: Unusual clinical course BACKGROUND: Percutaneous endos...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588675/ https://www.ncbi.nlm.nih.gov/pubmed/26402902 http://dx.doi.org/10.12659/AJCR.895098 |
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author | Rafiq, Arsalan Abbas, Naeem Tariq, Hassan Nayudu, Suresh Kumar |
author_facet | Rafiq, Arsalan Abbas, Naeem Tariq, Hassan Nayudu, Suresh Kumar |
author_sort | Rafiq, Arsalan |
collection | PubMed |
description | Patient: Female, 76 Final Diagnosis: Septic shock secondary to liver abscesses and gastro-hepatic fistula from PEG displacement Symptoms: Acute delirium Medication: — Clinical Procedure: None Specialty: Gastroenterology and Hepatology OBJECTIVE: Unusual clinical course BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a procedure used most commonly for enteral access for nutrition and continuation of treatment in patients when oral nutrition is not possible. It is a safe, cost-effective procedure; however, has its own complications and adverse effects that can be life threatening. CASE REPORT: Here, we present the case of a 76-year-old woman who was sent to a long-term skilled nursing facility after discharge from a hospital a month before, initially admitted for seizures after a fall and diabetic ketoacidosis. She underwent tracheostomy for prolonged respiratory support on mechanical ventilation and also underwent PEG tube placement. She presented in our Emergency Department (ED) with septic shock and multi-organ failure initially attributed to urinary tract infection and possible Clostridium difficile colitis. However, on further evaluation she was found to have a dislodged PEG tube, which led to development of gastro-hepatic fistula and multiple liver abscesses with liver necrosis. Comfort measures were implemented and she died due to her critical condition. CONCLUSIONS: To the best of our knowledge, this is the first case of a PEG tube, with no post-procedure complications, that dislodged and resulted in formation of a gastro-hepatic fistula and multiple liver abscesses. It is the first case that describes liver injury resulting from dislodgement rather than the liver being injured during the procedure of PEG tube placement itself. |
format | Online Article Text |
id | pubmed-4588675 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-45886752015-10-07 Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure Rafiq, Arsalan Abbas, Naeem Tariq, Hassan Nayudu, Suresh Kumar Am J Case Rep Articles Patient: Female, 76 Final Diagnosis: Septic shock secondary to liver abscesses and gastro-hepatic fistula from PEG displacement Symptoms: Acute delirium Medication: — Clinical Procedure: None Specialty: Gastroenterology and Hepatology OBJECTIVE: Unusual clinical course BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a procedure used most commonly for enteral access for nutrition and continuation of treatment in patients when oral nutrition is not possible. It is a safe, cost-effective procedure; however, has its own complications and adverse effects that can be life threatening. CASE REPORT: Here, we present the case of a 76-year-old woman who was sent to a long-term skilled nursing facility after discharge from a hospital a month before, initially admitted for seizures after a fall and diabetic ketoacidosis. She underwent tracheostomy for prolonged respiratory support on mechanical ventilation and also underwent PEG tube placement. She presented in our Emergency Department (ED) with septic shock and multi-organ failure initially attributed to urinary tract infection and possible Clostridium difficile colitis. However, on further evaluation she was found to have a dislodged PEG tube, which led to development of gastro-hepatic fistula and multiple liver abscesses with liver necrosis. Comfort measures were implemented and she died due to her critical condition. CONCLUSIONS: To the best of our knowledge, this is the first case of a PEG tube, with no post-procedure complications, that dislodged and resulted in formation of a gastro-hepatic fistula and multiple liver abscesses. It is the first case that describes liver injury resulting from dislodgement rather than the liver being injured during the procedure of PEG tube placement itself. International Scientific Literature, Inc. 2015-09-24 /pmc/articles/PMC4588675/ /pubmed/26402902 http://dx.doi.org/10.12659/AJCR.895098 Text en © Am J Case Rep, 2015 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License |
spellingShingle | Articles Rafiq, Arsalan Abbas, Naeem Tariq, Hassan Nayudu, Suresh Kumar Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure |
title | Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure |
title_full | Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure |
title_fullStr | Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure |
title_full_unstemmed | Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure |
title_short | Gastro-Hepatic Fistula with Liver Abscess: A Rare Complication of a Common Procedure |
title_sort | gastro-hepatic fistula with liver abscess: a rare complication of a common procedure |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588675/ https://www.ncbi.nlm.nih.gov/pubmed/26402902 http://dx.doi.org/10.12659/AJCR.895098 |
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