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Clement C H Wu,James W Li,Keng Sin Ng,Daphne S Ang 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.1
Percutaneous endoscopic gastrostomy (PEG) is commonly performed for feeding diffculties, in patients suffering from complicationsof nasopharyngeal carcinoma (NPC) and its treatment, namely radiotherapy and surgery. This case report describes the challenges inhemostasis and subsequent re-establishment of enteral access for feeding, in an elderly patient with a history of NPC, treated surgically,followed by radiotherapy, who presented with massive hematemesis following reinsertion of her PEG shortly after an accidentaldislodgement. Her previous nasopharyngectomy, wide field radiation therapy, and radical neck dissection precluded nasogastric tubefeeding, and the presence of a large hiatus hernia made reinsertion of a new PEG technically challenging. This case highlights themethods used to overcome the above challenges.