A two-year-old girl with two weeks of abdominal pain, vomiting, and food refusal, ten months after percutaneous endoscopic gastrostomy insertion because of inadequate peroral intake, was admitted to a tertiary centre hospital. On admission, the extracorporeal part of the gastrostomy was much shortened. X-ray examination revealed migration of the end of the gastrostomy tube with a left-shifted course of the tube through the duodenum. Gastroscopy and subsequently laparotomy were performed. A longitudinal pressure necrosis was identified under the tube, with two perforations in the duodenojejunal region. Ten centimeters of that duodenojejunal region were resected, and end-to-end anastomosis was made. The migration of the gastrostomy was probably caused by insufficient care by the parents. Pathophysiologically, the tube caused the pressure necrosis in the duodenojejunal area; this was supported by histology. This is a hitherto undescribed complication of a percutaneous endoscopic gastrostomy, showing that migration of the gastrostomy to the deeper part of the small bowel can lead to pressure necrosis, a potentially life-threatening condition in children which cannot be treated without invasive procedures.

• MeSH
• duodenum patologie   MeSH
• enterální výživa MeSH
• gastroskopie MeSH
• gastrostomie škodlivé účinky   MeSH
• lidé MeSH
• nekróza etiologie   MeSH
• nemoci duodena etiologie   chirurgie   MeSH
• odstranění implantátu MeSH
• perforace střeva etiologie   chirurgie   MeSH
• předškolní dítě MeSH
• selhání protézy škodlivé účinky   MeSH
• tlak škodlivé účinky   MeSH
• zaváděcí katétry škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH