Colon Injury During PEG Tube Insertion with Colic Fistula

 

Patient selection: PEG tube insertion

 

Clinically the diagnosis of acute injury to the colon may be difficult to make if the patient has multiple comorbid conditions. CT scan or other imaging studies may be needed to evaluate the patient.

 

Fistulas that may occur:

(1) colocutaneous

(2) gastrocolocutaneous

 

The presentation of a gastrocolonic fistula may be sudden onset of transient diarrhea very soon after delivery of a PEG tube feeding. In a patient with a suspected fistula injection of water-soluble contrast material with imaging studies can show the defect.

 

Other presentations:

(1) upper abdominal pain or discomfort

(2) fecal drainage through the fistula