A RARE COMPLICATION IN A CASE OF PERSISTENT DIARRHEA: PEG CATHETER MIGRATION

Percutaneous endoscopic gastrostomy is a common procedure performed for enteral feeding for patients who experience difficulty swallowing.Although generally safe, complications like infection, hemorrhage, gastrointestinal perforation, peritonitis, fistulisation, internal organ damage, and clogging of the catheter may occur.One of the rare complications is the misplacement of the percutaneous endoscopic gastrostomy catheter into neighboring organs or the migration of the catheter with time.In this case report, we focused on the diagnosis and treatment of persistent diarrhea due to migration of a percutaneous endoscopic gastrostomy catheter into the transverse colon.A 70-year-old patient, with a history of cerebrovascular accident and who was under follow-up for inoperable lung cancer, was started on enteral feeding via a percutaneous endoscopic gastrostomy catheter due to dysphagia.A year later, the patient was admitted to the general surgery ward after applying to the emergency room experiencing watery diarrhea more than ten times a day that had been going on for a month.During evaluation, differential diagnoses of diarrhea including infectious, enteral feeding-related, and drug-associated causes were considered.An abdominal computed tomography revealed that the catheter had migrated to the transverse colon level.Subsequently, esophagogastroduodenoscopy and colonoscopy confirmed that the catheter was not in the stomach, but rather in the lumen of the transverse colon.The catheter was removed endoscopically and after the procedure, a new percutaneous endoscopic gastrostomy catheter has been inserted without complications.This case emphasizes the importance of recognizing and appropriately managing a rare complication of percutaneous endoscopic gastrostomy.In patients presenting with gastrointestinal symptoms such as persistent diarrhea, a detailed history should be taken and this complication should be considered.