Abdominal wall necrotising fasciitis due to dislodged percutaneous endoscopic gastrostomy tube

Accessing the stomach via a percutaneous endoscopic gastrostomy (PEG) tube is the preferred (and sometimes the only) method for providing enteral nutritional support in disabled patients. However, it is associated with serious and potentially lethal complications which must be completely recognised by physicians, by nurses and especially by radiologists. Abdominal wall necrotising fasciitis of a dislodged or leaking PEG tube could be a lethal complication. We present a case of a 74-year-old bed bound woman who was admitted to our hospital with fever and abdominal pain. On presentation, the patient's temperature was 36°C and laboratory tests showed leucocytosis. Physical examination revealed extensive redness of the abdominal wall, diffuse tenderness of the abdomen and yellowish discharge around the gastrostomy.