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Shinya Taki,Takao Maekita,Mayumi Sakata,Kazuhiro Fukatsu,Yoshimasa Maeda,Mikitaka Iguchi,Hidefumi Ito,Masayuki Kitano 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.6
Continuous duodenal levodopa/carbidopa intestinal gel delivery by a gastrostomy infusion system improves control of Parkinson’sdisease. The overall complication rates of percutaneous endoscopic gastrojejunostomy were reported to be 41% and 59% for immediateand delayed adverse events, respectively. A 72-year-old woman underwent percutaneous endoscopic gastrojejunostomy using thedelivery system noted above. Abdominal pain and vomiting occurred 3 months later. Esophagogastroduodenoscopy showed alongitudinal ulcer extending from the lower gastric body to the ileum end, with small intestinal telescoping. Colonoscopy showed alarge bezoar of food residue that was attached around the tip of the tube, reaching the ascending colon, which may have acted as ananchor. Thus, the gastric antrum and small intestine were shortened with telescoping. This complication was resolved by crushing thebezoar with forceps during colonoscopy and can be prevented by consuming a fiber-free diet and periodic exchanges of the tube usingesophagogastroduodenoscopy.