Peritonitis after percutaneous endoscopic gastrostomy and jejunostomy: where there is smoke, there may not be fire

Extensive reviews have been published regarding complications arising from percutaneous enteral access and ways of managing them. However, few data are available regarding unnecessary clinical interventions resulting from misinterpretation of benign postprocedural findings. We present here three representative cases of negative surgical abdominal cavity explorations for presumed peritonitis after percutaneous endoscopic gastrojejunostomy and jejunostomy.

References

• 1 Gauderer M W, Ponsky J L, Iznat R J. Gastrostomy without laparotomy: a percutaneous endoscopic technique.  J Pediatr Surg. 1980;  15 872-875
• 2 Ponsky J L, Aszodi A. Percutaneous endoscopic jejunostomy.  Am J Gastroenterol. 1984;  79 113-116
• 3 McClave S A, Chang W K. Complications of enteral access.  Gastrointest Endosc. 2003;  58 739-751
• 4 Gottfried E B, Plumser A B, Clair M R. Pneumoperitoneum following percutaneous endoscopic gastrostomy.  Gastrointest Endosc. 1986;  32 397-399
• 5 Duckworth P F jr, Kirby D F, McHenry L. et al . Percutaneous endoscopic gastrojejunostomy made easy: a new over-the-wire technique.  Gastrointest Endosc. 1994;  40 350-353
• 6 Wojotowycz M M, Arata J A, Micklos T J. et al . CT findings after uncomplicated percutaneous gastrostomy.  AJR Am J Roentgenol. 1988;  151 307-309
• 7 Pidala M J, Slezak F A, Porter J A. Pneumoperitoneum following percutaneous endoscopic gastrostomy: does the timing of panendoscopy matter?.  Surg Endosc. 1992;  6 128-129
• 8 Dulabon G R, Abrams J E, Rutherford E J. The incidence and significance of free air after percutaneous endoscopic gastrostomy.  Am Surg. 2002;  68 590-593