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Gastrocolic Fistula with Migration of Feeding Tube into Transverse Colon as a Complication of Percutaneous Endoscopic Gastrostomy

Steven Y. Huang1, Marc S. Levine1 and Steven E. Raper2

1 Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.
2 Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA.



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  		Fig. 1A. —44-year-old man with gastrocolic fistula and migration of feeding tube into transverse colon as complication of percutaneous endoscopic gastrostomy (PEG). Digital scout image of upper abdomen shows how mushroom (white arrow) at end of PEG tube is located outside of lumen of gas-filled stomach (black arrows).

 


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  		Fig. 1B. —44-year-old man with gastrocolic fistula and migration of feeding tube into transverse colon as complication of percutaneous endoscopic gastrostomy (PEG). Frontal spot image from radiographic study with water-soluble contrast material (diatrizoate meglumine and diatrizoate sodium [Gastroview]; Mallinckrodt) shows tip of tube in lumen of transverse colon (black arrow denotes mushroom at end of tube) with antegrade colonic filling to splenic flexure and retrograde filling of proximal transverse colon. A thin track (long white arrows) extending superiorly from transverse colon at site of PEG tube to gastric fundus is opacified, with a tiny amount of contrast material entering lumen of fundus (short white arrow), indicating presence of gastrocolic fistula.

 

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