Figure 3.55. "Lost" gastrostomy tube causing small-bowel obstruction. (A) Plain film of the abdomen showing small-bowel obstruction. The radiopaque portion of the tube is present in the
right lower quadrant, and difficult to identify. Contrast medium is present in the rectum from a previous examination. (B) Radiograph of the gas-trostomy tube showing the radiopaque portion.
necrosis from the balloon (Fig. 3.56). Other rarer complications include gastric pneumatosis, which has been reported in association with gastric outlet obstruction and/or intramural position of the tube (Fig. 3.57), gastrocutaneous fistula after tube removal, gastrocolic fistula (Fig. 3.58), intraperitoneal leakage, and hemorrhage after percutaneous placement. Gastropexy may cause the stomach to assume a character-
Figure 3.57. Gastric emphysema secondary to gastric outlet obstruction from gastrostomy tube. Oblique view from a water-soluble contrast study through the gastrostomy tube showing gastric outlet obstruction and gastric emphysema secondary to impaction of the tube at the pyloric channel.
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