Pneumoperitoneum with Subcutaneous Emphysema after Percutaneous Endoscopic Gastrostomy

Table 1

Complications of PEG procedure.

Due to the endoscopy procedure	Due to the PEG and the gastrostomy tube	Due to the mode of feeding
(i) Laryngospasm, airway obstruction; (ii) Aspiration and pneumonia; (iii) Respiratory depression or apnea; (iv) Desaturation or respiratory distress and acute respiratory failure; (v) Hypertension; (vi) Fracture of the alveolar ridge while attempting to open the mouth	(i) Perforation/laceration of the oesophagus or the stomach; (ii) Transhepatic insertion of the tube; (iii) Pneumoperitoneum; (iv) Colonic perforation; (v) Subcutaneous emphysema; (vi) Retroperitoneal hemorrhage; (vii) Aortic perforation; (viii) Erosion of the gastric mucosa and bleeding; (ix) Hematoma or infection of the abdominal wall; (x) Gastrocolic fistula; (xi) Colocutaneous fistula; (xii) Hypertrophic granulation tissue at the gastrostomy exit; (xiii) Buried bumper syndrome; (xiv) Malpositioning of the tube or leakage; (a) To the subcutaneous tissues → cellulitis, myositis, necrotizing fasciitis, subcutaneous abscess.; (b) To the peritoneal cavity → peritonitis, intraabdominal abscess, sepsis.; (xv) Migration of the tip of the gastrostomy tube; (a) To oesophagus (oesophagitis); (b) To pylorus (obstruction or perforation of the duodenum); (xvi) Migration of the whole PEG tube up to the terminal ileum; (xvii) Peristomal hernia or stomal prolapse; (xviii) Accidental pulling out or cutting off the tube close to the skin during home care; (xix) Erosion of the tube through the gastric wall; (xx) Obstruction of the tube lumen; (xxi) Hub detachment or damage; (xxii) Later symptomatic gastroesophageal reflux; (xxiii) Ileus	(i) Diarrhoea; (ii) Nausea; (iii) Vomiting; (iv) Dumping syndrome; (v) Ogilvie’s syndrome; (vi) Aspiration pneumonia; (vii) Constipation and meteorism