A Nasogastric Tube Inserted into the Gastrocutaneous Fistula
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
We reported a case in which a nasogastric tube was inserted into the gastrocutaneous fistula, diagnosed by abdominal computed tomography. A 78-year-old man with a history of recurrent cerebral hemorrhage had a percutaneous endoscopic gastrostomy tube due to dysphagia for 2 years. However, soft tissue infection at the gastrostomy site caused the removal of the tube. Immediately, antibiotic agents were infused. For appropriate hydration and medication, a nasogastric tube was inserted. However, there was no significant improvement of the soft tissue infection. Moreover, the amount of bloody exudate increased. Abdominal computed tomography revealed the nasogastric tube placed under the patient’s skin via gastrocutaneous fistula. The nasogastric tube was removed, and an antibiotic agents were maintained. After 3 weeks, the signs of infection fully improved,and percutaneous endoscopic gastrostomy was performed again. This case shows necessities of an appropriate interval between removal of the gastrostomy tube and insertion of a nasogastric tube, and suspicion of existence of gastrocutaneous fistula.
Abstract
We reported a case in which a nasogastric tube was inserted into the gastrocutaneous fistula, diagnosed by abdominal computed tomography. A 78-year-old man with a history of recurrent cerebral hemorrhage had a percutaneous endoscopic gastrostomy tube due to dysphagia for 2 years. However, soft tissue infection at the gastrostomy site caused the removal of the tube. Immediately, antibiotic agents were infused. For appropriate hydration and medication, a nasogastric tube was inserted. However, there was no significant improvement of the soft tissue infection. Moreover, the amount of bloody exudate increased. Abdominal computed tomography revealed the nasogastric tube placed under the patient’s skin via gastrocutaneous fistula. The nasogastric tube was removed, and an antibiotic agents were maintained. After 3 weeks, the signs of infection fully improved,and percutaneous endoscopic gastrostomy was performed again. This case shows necessities of an appropriate interval between removal of the gastrostomy tube and insertion of a nasogastric tube, and suspicion of existence of gastrocutaneous fistula.
참고문헌 (10)
- Veis SL, "Swallowing disorders in persons with cerebrovascular accident", Arch Phys Med Rehabil, 66, pp.372~375 (1985)
- Penington GR, "Swallowing disorders: assessment and rehabilitation", Br J Hosp Med, 44, pp.17~22 (1990)
- Raha SK, "Who should have a PEG?", Age Ageing, 22, pp.313~315 (1993)
- Pien EC, "Gastrostomy tube infections in a community hospital", Am J Infect Control, 24, pp.353~358 (1996)
- Wynne DM, "Nasogastric tube misplacement into Eustachian tube", Int J Pediatr Otorhinolaryngol, 67, pp.185~187 (2003)
- Sorokin R, "Enhancing patient safety during feeding-tube insertion: a review of more than 2000 insertions", J Parenter Enter Nutr, 30, pp.440~445 (2006)
- Rahimi-Movaghar V, "Intracranial placement of a nasogastric tube. A lesson to be re-learnt?", Acta Neurochir, 147, pp.573~574 (2005)
- Aronian JM, "Gastrocutaneous fistula after tube gastrostomy. Incidence in infants and children", N Y State J Med, 74, pp.2364~2366 (1974)
- Kobak GE, "Complications of removing percutaneous endoscopic gastrostomy tubes in children", J Pediatr Gastroenterol Nutr, 30, pp.404~407 (2000)
- Siddiqui AA, "Closure of a nonhealing gastrocutaneous fistula using an endoscopic clip", South Med J, 100, pp.75~76 (2007)
