Small bowel obstruction caused by intraluminal migration of retained percutaneous endoscopic gastrostomy internal bumper.

INTRODUCTION

Early complications associated with percutaneous endoscopic gastrostomy are well documented. Late complications associated with retained gastrostomy flange are rare. It is unclear why some patients with retained gastrostomy flange (internal bumper) develop mechanical obstruction and others do not. We report a case of mechanical obstruction with perforation occurring 6 months after the tube was cut.

PATIENT AND

METHODS

A 76-year-old hemiplegic patient with no swallowing reflex and who previously was on long-term percutaneous gastrostomy feeding tube underwent removal of the feeding tube but the internal bumper was left in situ due to encrustation.

RESULTS

Due to migration of the retained flange, the patient developed small bowel obstruction.

CONCLUSIONS

Retained internal bumper is potentially dangerous and we recommend endoscopic retrieval of such flange.