Gastric Outlet Obstruction due to Malposition of Gastrostomy Tube: A Rare and Commonly Misdiagnosed Condition

Abstract

Nearly all disease processes worsen with malnutrition. However, providing adequate and optimal nourishment can be challenging in individuals who are not able to eat. Insertion of a gastrostomy tube is a well-established method for providing enteral access for long-term nutritional support. Although enteral tube feedings are generally well tolerated, gastrostomy tube placement is associated with several complications. An uncommon, and often initially misdiagnosed, complication of gastrostomy tube placement is gastric outlet obstruction (GOO), which refers to the clinical outcome of any disease process that mechanically obstructs gastric emptying. GOO is a clinical syndrome characterized by nausea, postprandial nonbilious vomiting, epigastric pain, early satiety, abdominal distention, and insidious weight loss due to mechanical obstruction in the distal stomach, pylorus, or duodenum. Rarely, migration and malposition of a gastrostomy tube can lead to this condition. Therefore, physicians should be aware of GOO as a rare complication of gastrostomy tube placement. Often, simple adjustment of the tube can lead to rapid improvement and resolution of the patient’s clinical condition as well as prevent needless medical tests, overly aggressive management, and further complications. Here, we present an interesting case of a woman who developed a GOO after unintended migration of a gastrostomy tube.