Case Report : Peg Tube Migration Associated With Acute Pancreatitis

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Case report: PEG tube migration associated with acute pancreatitis Amer hawatmeh, Anas Al-khateeb Abstract Context: Association between PEG tube dislodgement with acute pancreatitis was cited in the literature, presumptively due to obstruction of the Ampulla of Vater. Case: We reported a case of PEG tube migration into the duodenum with associated acute pancreatitis. Conclusion: recognition of the possibility of disturbed biliary flow in the setting of PEG tube migration to the duodenum as possible predisposing factor in acute pancreatitis in patients with PEG tube. Case report A 76 year old Hispanic female, with past medical history of Alzheimer dementia, functional quadriplegia, oropharyngeal dysphagia with a 24 Fr PEG tube…show more content…
Abdominal ultrasound showed distended gallbladder with a sludge, no new changes since last episode of acute pancreatitis, CBD diameter was 2 mm. CT scan of the abdomen revealed PEG tube balloon and tip in the second/third portion of the duodenum without evidence of acute pancreatitis. A diagnosis of acute pancreatitis was made based on high lipase and abdominal pain. At bedside the PEG tube was pulled back to stomach. Within the following 2 days, all of her symptoms improved, with near normal resolution of her lipase, alkaline phosphatase, and creatinine. Patient was discharged after 2 days of admission. Discussion PEG tube placement has become one of the common aspects in caring for patients with long term oropharyngeal dysphagia. Ten percent of nursing home residents and 1.7% of Medicare patients over the age of 85 years undergo gastrostomy tube
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