Gastric outlet and duodenal bulb obstruction: A rare complication due to migrated gastrostomy tube.

Percutaneous endoscopic gastrostomy (PEG), became a common option for extended enteral nutritional support. Placing a PEG tube is generally considered as a safe procedure, Nevertheless, mild to severe complications may occur. A 73-year-old female presented to our outpatient clinic with nausea, vomiting and weight loss. She had a PEG tube placed due to inadequate oral intake secondary to nasopharyngeal malignancy. She was fed via PEG tube since then. It was renewed six months ago. Gastroscopy revealed migrated internal bumper of the tube passing through anterior wall of gastric corpus to duodenal bulb through pylorus and causing an obstruction. Although it is rare, migration of the PEG tube may cause gastrointestinal obstruction. Nausea, vomiting, abdominal pain and/or weight loss may be present. As a minor-late complication, gastric outlet and duodenal bulb obstruction was detected in our case. Generally, symptoms are resolved with replacing the tube by external traction.