Gastrocolocutaneous fistula in a child with congenital short bowel syndrome: a rare complication of percutaneous endoscopic gastrostomy.

Gastrocolocutaneous fistula is a rare major complication of percutaneous endoscopic gastrostomy (PEG). We report a case of this complication in a 2-year-old boy with congenital short bowel syndrome with dilated bowel loops who underwent PEG insertion. Fever developed and stool-like substance was discharged from the gastrostomy tube 1 year later. Further upper gastrointestinal study and panendoscopy revealed a gastrocolonic and colocutaneous fistula. He underwent laparotomy to close the fistula. The recovery was uneventful and he was discharged 10 days after surgery. This case suggests that a previous history of abdominal surgery or dilated bowel loops should be a relative contraindication to PEG procedure. Open surgical gastrostomy is recommended for such patients.