Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2022; 14(6): 621-625
Published online Jun 27, 2022. doi: 10.4240/wjgs.v14.i6.621
Bowel intussusception caused by a percutaneously placed endoscopic gastrojejunostomy catheter: A case report
Maarten WJ Winters, Sjoerd Kramer, Albert HA Mazairac, Ewoud H Jutte, Paul G van Putten
Maarten WJ Winters, Sjoerd Kramer, Paul G van Putten, Department of Gastroenterology and Hepatology, Medical Center Leeuwarden, Leeuwarden 8934 AD, Netherlands
Albert HA Mazairac, Department of Radiology, Medical Center Leeuwarden, Leeuwarden 8934 AD, Netherlands
Ewoud H Jutte, Department of Surgery, Medical Center Leeuwarden, Leeuwarden 8934 AD, Netherlands
Author contributions: All authors were involved in the care of the patient; Winters MW and Kramer S reviewed the literature and contributed to the manuscript drafting; van Putten PG, Mazairac AH and Jutte EH revised the manuscript for important intellectual content; and all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maarten WJ Winters, MD, Doctor, Department of Gastroenterology and Hepatology, Medical Center Leeuwarden, Henri Dunantweg 2, Leeuwarden 8934 AD, Netherlands. m.w.j.winters@gmail.com
Received: November 25, 2021
Peer-review started: November 25, 2021
First decision: January 8, 2022
Revised: January 23, 2022
Accepted: May 16, 2022
Article in press: May 16, 2022
Published online: June 27, 2022
Abstract
BACKGROUND

In adults, bowel intussusception is a rare diagnosis and is mostly due to an organic bowel disorder. In rare cases, this is a complication of a percutaneously placed endoscopic gastro (jejunostomy) catheter.

CASE SUMMARY

We describe a case of a 73-year-old patient with a history of myocardial infarction, chronic idiopathic constipation and Parkinson’s disease. For the admission of his Parkinson’s medication, a percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) was placed. The patient presented three times at the emergency department of the hospital with intermittent abdominal pain with nausea and vomiting. There were no distinctive abnormalities from the physical and laboratory examinations. An abdominal computed tomography scan showed a small bowel intussusception. By push endoscopy, a jejunal bezoar at the tip of the PEG-J catheter was found to be the cause of small bowel intussusception. The intussusception was resolved after removing the bezoar during push enteroscopy.

CONCLUSION

Endoscopic treatment of bowel intussusception caused by PEG-J catheter bezoar.

Keywords: Bowel intussusception, Percutaneous endoscopic gastrojejunostomy, Bezoar, Percutaneous endoscopic gastrostomy, Case report

Core Tip: In patients with a proximal feeding catheter and complaints of acute or intermittent abdominal pain, intussusception must be considered. An abdominal computed tomography scan is recommended for additional investigation. If small bowel intussusception is present/suspected, we recommend first investigating the cause via gastroscopy/push enteroscopy and, if possible, treating it endoscopically immediately so that surgery can be prevented.