Supplemental Material for: Minimally Invasive Management of Transverse Colon Transfixation Following Percutaneous Endoscopic Gastrostomy – a Case Report

On postprocedural day five, she developed fever, peri-ostomal cellulitis and rising inflammatory markers. Computed tomography revealed correct intragastric PEG position but interposition and partial transfixation of the transverse colon between the stomach and the abdominal wall. The patient underwent diagnostic laparoscopy that confirmed transcolonic PEG placement without intra-abdominal contamination.

The tube was removed, both colonic defects were repaired laparoscopically, and a new surgical gastrostomy was fashioned under direct visualization. The patient resumed enteral feeding on postoperative day one and was discharged in stable condition after completing antibiotic therapy.</p><p dir="ltr">Conclusion: Transcolonic PEG misplacement is an uncommon but significant complication that should be considered in patients with atypical postprocedural evolution.

Early diagnosis with cross-sectional imaging and a minimally invasive surgical approach allow safe management while preserving enteral access and preventing further morbidity.</p>