Percutaneous endoscopic gastrostomy (PEG) has become the procedure of choice for long-term enteral feeding. Complications are generally infrequent and often avoidable. We describe an unusual case in which a PEG tube bumper caused subcutaneous perforation of an ileostomy. After conservative treatment proved unsuccessful, revision of the ileostomy via a peristomal incision was performed, with good result. Caution must be exercised before considering the severance of a PEG tube at the skin, especially in patients with an ileostomy.
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