CASE REPORT article
Front. Surg.
Sec. Visceral Surgery
This article is part of the Research TopicState of the Art in Acute Care Surgery: Application, Innovation, and Future PerspectivesView all 14 articles
Case report: triple gastro-colic fistula after percutaneous endoscopic gastrostomy placement
Provisionally accepted
Matteo Pittacolo
Marco Brolese*
Arianna Vittori
Daniele PasseriRenato SalvadorValeria ValliLorenzo ValleseNicola BaldanGianfranco Da Dalt
Michele ValmasoniAlberto Friziero- Universita degli Studi di Padova Dipartimento di Scienze Chirurgiche Oncologiche e Gastroenterologiche, Padua, Italy
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Abstract Background: Percutaneous endoscopic gastrostomy (PEG) is a widely accepted procedure for long-term enteral nutrition. Although generally safe, rare but life-threatening complications can occur. We report a unique case of a triple gastro-colic fistula, identified during an emergency surgical intervention after radiological replacement of a PEG one year following its initial placement. Case Presentation: An 83-year-old man with Parkinson's-related dysphagia underwent PEG placement. One year later, following catheter occlusion, it was replaced radiologically. The next day, the patient developed abdominal pain and diarrhea, and imaging revealed catheter misplacement into the transverse colon. Surgical exploration identified three chronic and dehiscent fistulous tracts involving the stomach, transverse colon, and sigmoid colon. The patient was treated with colonic resection, gastric double-layer suture, and surgical gastrostomy. Recovery was uneventful and the patient was discharged on postoperative day eight. Conclusion: This is the first reported case of a triple gastro-colic fistula following PEG placement. The case highlights that early recognition and multidisciplinary management of PEG-related complications are crucial. Prompt diagnosis and the availability of a specific Acute Care Department are essential for the effective management of such complex scenarios.
Keywords: Gastrostomy, complications, Intestinal Perforation, Fistula, Large bowel resection
Received: 08 Aug 2025; Accepted: 05 Nov 2025.
Copyright: © 2025 Pittacolo, Brolese, Vittori, Passeri, Salvador, Valli, Vallese, Baldan, Da Dalt, Valmasoni and Friziero. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Marco Brolese, marco.brolese.1@studenti.unipd.it
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