A case of emphysematous gastritis after percutaneous endoscopic gastrostomy

A man in his 80s was scheduled to undergo percutaneous endoscopic gastrostomy (PEG) because he was at high risk for aspiration due to Parkinson's disease. PEG was performed using the modified introducer technique with the EndoVive Seldinger PEG kit 24 Fr 3.5 cm (Boston Scientific Japan, Tokyo, Japan). The device through which the PEG tube would be connected was implanted on the anterior wall of the middle gastric body by endoscopy. Enteral nutrition and drug infusion were started the following day. Eleven days after implantation of the device, the patient experienced abdominal pain and hematemesis, and went into shock (day 0). Abdominal computed tomography revealed emphysematous gastritis, and intravenous administration of norepinephrine and antibiotics was started. His overall condition improved, and he was discharged on day 42. Although the occurrence of gastric emphysema after PEG is rare, conservative management can ensure recovery in such patients.