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首页> 外文期刊>European journal of gastroenterology and hepatology >Percutaneous endoscopic gastrostomy tube occlusion in malignant peritoneal carcinomatosis-induced bowel obstruction.
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Percutaneous endoscopic gastrostomy tube occlusion in malignant peritoneal carcinomatosis-induced bowel obstruction.

机译：经皮内镜下胃造口术管阻塞在恶性腹膜癌病引起的肠梗阻中。

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OBJECTIVE: Percutaneous endoscopic gastrostomy (PEG) tube placement for decompression in advanced peritoneal carcinomatosis with bowel obstruction is a safe and feasible palliative procedure. We describe a rare, previously unreported phenomenon of PEG tube occlusion by gastric mucosal herniation. METHODS: A consecutive case series of 73 patients with advanced abdominal carcinomatosis-induced bowel obstruction from January 2007 to June 2010. All patients had a 28 Fr (Bard) PEG tube placed for drainage. None of them were surgical candidates due to extensive peritoneal involvement. Patients with PEG tube occlusion as a result of gastric mucosal herniation were further evaluated. RESULTS: Nineteen patients were men and 54 were women. The mean age was 53.3 years. The most common cancer types were ovary, pancreas, colon, and stomach. All patients had PEG tube functioning well after the procedure with immediate relief of obstructive symptoms. Subsequently, 10 patients developed acute occlusion of PEG tubes with reoccurrence of obstructive symptoms. The time between the placement of the PEG tube and its occlusion ranged from 5 to 129 days. Repeat endoscopy showed the PEG tube occluded with gastric mucosa from the opposite wall. PEG tube was replaced with a 28 Fr balloon replacement tube leading to symptom improvement in all 10 patients. CONCLUSION: This rare but correctable phenomenon of obliteration of PEG tube from the gastric mucosa should be considered in any patient who develops intermittent occlusive symptoms. This phenomenon can be corrected by replacing the PEG tube with a ballooned replacement tube as well as occasional manipulation of the tube.
机译：目的：经皮内镜下胃造口术（PEG）管置入术治疗晚期腹膜癌伴肠梗阻减压是一种安全可行的姑息治疗方法。我们描述了一种罕见的，以前未报道的通过胃粘膜疝的PEG管阻塞现象。方法：自2007年1月至2010年6月，连续病例系列73例晚期腹部癌病引起的肠梗阻。所有患者均放置了28 Fr（Bard）PEG管引流。由于广泛的腹膜受累，他们都不是手术候选人。进一步评估了因胃粘膜突出而导致PEG管阻塞的患者。结果：男19例，女54例。平均年龄为53.3岁。最常见的癌症类型是卵巢癌，胰腺癌，结肠癌和胃癌。手术后所有患者的PEG管功能均良好，可立即缓解阻塞性症状。随后，有10例患者发生了PEG管的急性阻塞，并再次出现阻塞性症状。从放置PEG管到阻塞之间的时间为5到129天。重复内窥镜检查显示PEG管从对面壁被胃粘膜阻塞。用28 Fr球囊置换管替换PEG管，从而改善所有10例患者的症状。结论：任何出现间歇性闭塞症状的患者均应考虑这种罕见但可纠正的胃粘膜PEG管闭塞现象。这种现象可以通过用膨胀的替换管替换PEG管以及偶尔操纵该管来纠正。

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