Use of a venting PEG tube in the management of recurrent acute gastric dilatation associated with Prader-Willi syndrome

Journal of Surgical Case Reports
Ahmed M A Mohammed, Robert J Dennis

Abstract

A patient with Prader-Willi Syndrome was admitted to the ICU with features of recurrent acute gastric dilatation, aspiration pneumonia and a massive pulmonary embolus. He was initially managed with intubation, assisted ventilation, intravenous fluids and anticoagulation. Decompression of the stomach was achieved with a nasogastric tube. After ventilator weaning, he did not tolerate the nasogastric intubation that led to a further episode of aspiration pneumonia as a result of non-resolving gastric dilatation. He required readmission to intensive care for a further period of ventilatory support. While the patient was sedated and ventilated, a venting percutaneous endoscopic gastrostomy (PEG) with a jejunal feeding extension was placed, permitting both continued decompression of the stomach and enteral feeding. The patient tolerated the PEG-J well and his nutritional needs were successfully addressed. Oral intake was slowly re-established with ongoing decompression of the stomach with the PEG. He was discharged from hospital with the PEG in place.

References

Jan 22, 2004·American Journal of Medical Genetics. Part a·Constance Th R M Schrander-StumpelJean-Pierre Fryns
Jan 23, 2008·Proceedings·Shawn SteenLaura Petrey

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