Abstract：
Percutaneous endoscopic gastrostomy (PEG) is widely used for long-term enteral nutrition in patients unable to maintain adequate oral intake. Despite advancements in PEG techniques, complications remain a concern. We report a case of a 94-year-old bedridden man who developed significant complications after PEG placement using the pull method. Initially, minor bleeding at the puncture site was managed using traction compression. However, the patient later experienced hemorrhagic shock owing to pulsatile bleeding around the gastrostomy site. Despite attempts to control the bleeding through traction and transfusions, a pseudoaneurysm adjacent to the PEG button was identified. The patient underwent successful transcatheter arterial embolization (TAE). Post-TAE, no further bleeding or hematoma was observed, and imaging confirmed the resolution of the pseudoaneurysm and hematoma. Methicillin-resistant Staphylococcus aureus (MRSA) infection was detected at the gastrostomy site, which contributed to complications. Despite successful management of the bleeding, the patient\'s overall condition deteriorated, and he died on postoperative day 66. This case underscores the importance of vigilant monitoring and management of PEG-related complications, particularly infections that may precipitate severe vascular events.
摘要：
经皮内镜胃造瘘术（PEG）被广泛用于无法维持足够口腔摄入量的患者的长期肠内营养。尽管PEG技术取得了进步，并发症仍然令人担忧。我们报告了一例94岁卧床不起的男子，该男子在使用拉力法放置PEG后出现了严重的并发症。最初，穿刺部位的轻微出血采用牵引加压治疗.然而,患者后来由于胃造口周围的搏动性出血而经历了失血性休克。尽管试图通过牵引和输血控制出血，在PEG按钮附近发现了假性动脉瘤.患者接受了成功的经导管动脉栓塞（TAE）。TAE后,没有观察到进一步的出血或血肿，影像学证实了假性动脉瘤和血肿的分辨率。在胃造口部位检测到耐甲氧西林金黄色葡萄球菌（MRSA）感染，这导致了并发症。尽管成功管理了出血，病人的整体状况恶化，他在术后第66天死亡.该病例强调了警惕监测和管理PEG相关并发症的重要性，尤其是可能导致严重血管事件的感染.
