Herniation through gastrostomy site: Case report

INTRODUCTION: Herniation through gastrostomy site is an extremely rare complication of percutaneous endoscopic gastrostomy (PEG). We present two unusual cases of gastrostomy site herniation, the surgical management thereof, and a corresponding review of the literature. CASE PRESENTATION: The first patient is a 65 year old Caucasian male who complained of epigastric pain and a bulge at his previous gastrostomy tube incision site three weeks after its removal. Initial exam revealed a hernia measuring approximately 10 cm which was later repaired by laparoscopic surgery with a composite mesh. The second case is 66 year old obese Caucasian male who complained of continued pain in the midepigastric region around his gastrostomy site scar five months after removal of his PEG tube. On physical exam he was found to have a hernia of 6 cm in the midepigastrium. His hernia was later repaired by open surgery with a composite mesh. Both patients recovered uneventfully postoperatively. CONCLUSION: Herniation through gastrostomy site is a possible complication of PEG tube and clinicians should consider this possibility in patients with ongoing leakage, bulge or pain at the gastrostomy site. This entity can be safely corrected via laparoscopic or open techniques.