Successful treatment of an iatrogenic gastro-colo-cutaneous fistula in a patient with Chilaiditi syndrome: A case report

Abstract

Chilaiditi syndrome is an occasional radiographic anomaly characterized by the interposition of the bowels between the liver and the diaphragm. The presence of Chilaiditi syndrome can cause serious problem on percutaneous endoscopic gastrostomy (PEG) procedure, because the anomalous position of the transverse colon can obstruct the procedure and might lead to occurrence of complications. Our report describes a PEG-induced gastro-colo-cutaneous fistula in a patient with Chilaiditi syndrome which resulted in minimally invasive laparoscopic gastrostomy. As most patients who need a PEG placement have impaired consciousness, the majority of PEG-related complications are overlooked or discovered long after the procedure. However, we recognized the complication immediately after the PEG procedure and successfully treated by laparoscopic surgery.

Keywords:

• PEG
• Chilaiditi syndrome
• laparoscopic surgery
• iatrogenic complication

Public Interest Statement

Our report is intended to alert that PEG procedure can cause complication of gastro-colo-cutaneous fistura in patients of Chilaiditi syndrome. Furthermore, we report and recommend low-invasive salvage surgery under laparoscopy if the complication was detected early.

Competing Interests

The authors declare no competing interest.

Additional information

Notes on contributors

Hokahiro Katayama

In our hospital we engage in general surgery. While the number of patients are small, we eagerly try to apply low invasive surgery.