Abstract
Percutaneous endoscopic gastrostomy (PEG), as described by Gauderer, Ponsky, and Izant/has achieved widespread recognition and application as an alternative to operative gastrostomy. The avoidance of celiotomy, its simplicity and low cost, as well as the minimal risks and complications of the procedure highlight the attractiveness of PEG.1-6 Several recent reports have described the occurrence of pneumoperitoneum after PEG.•• These papers have demonstrated pneumoperitoneum to be selflimited, resolving within 1 week, and it was concluded that recognition of the benign nature of this transient complication should temper the enthusiasm for operative intervention. We report a patient who developed a massive tension pneumoperitoneum following PEG that persisted for 5 weeks, finally prompting laparotomy.
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