Acute colon pseudo-obstruction after percutaneous endoscopic gastrostomy: An unusual co-incidence in a case of acute stroke

Abstract

Percutaneous endoscopic gastrostomy (PEG) is a standard procedure for enteral feeding tube placement in the stomach for patients with nonobstructive dysphagia. Major and minor complications have been described in early and delayed phase. We describe a 57-year-old hypertensive male patient who underwent PEG for nonobstructive dysphagia after an acute cerebro-vascular accident that presented as right hemiplegia due to pontine hemorrhage. Patient went on to develop nonobstructive spontaneous acute colon dilation from cecum to rectum 72 h after the procedure. Computed tomography scan of the abdomen was undertaken to rule out mechanical obstruction or colon entrapment. Injection Neostigmine was used on day 10 after PEG as there was a recurrence after initial partial resolution. Thereafter patient had an uneventful recovery.

Keywords

• abdomen distension
• cerebro-vascular accident
• colonic ileus
• dysphagia
• enteral feed
• megacolon