My friend's husband had tongue cancer and had PEG tube (feeding tube) inserted last November. He has finished his cancer treatments and this week had the tube removed...in the doctor's office! Can you believe it? Doc just yanked it out and told him to only have liquids for 3 hours and then he could go play golf.

But here is my question. There is a hole in the stomach and a hole in the abdominal wall...but no stitches or any method of closure was used. How can someone walk around with a hole in their stomach? I believe it is called a gastrocutaneous fistula and is suppose to heal on it's own within hours but I'd like to know the mechanics involved.

Perfectly normal way to handle it. I assume by now you've confirmed it's healed.

Sid, my question was how does the stomach manage to close up that internal hole, why isn't it closed surgically? What keeps the stomach acids from coming out of it? How does the stomach tissue heal itself and close the hole?

I just can't fathom having a hole inside your body...

Two weeks and still no answer? That's not like you guys.

Still want to why a hole that is left in the stomach is not surgically closed and how the stomach manages to heal so quickly and what prevents the acid from seeping out before the hole closes.

Thanks

I can only make an educated guess Georgia, I do not know for sure.

But, if someone has a peg tube for a period of time, the original site would have to build up scar tissue. Possibly that scar tissue would immediately adhere to itself when the tube is removed?

I have changed peg tubes in past jobs, and I can attest to no stomach contents leaking out.

Interesting thought Shel.

I'm really surprised that with all my research these past weeks I have found nothing explaining this on a physiological level. Everything just talks about the removal and that surgical closure is not necessary.

Thanks for your input and perhaps someone can add to it. Where is the doctor in the house?

I consulted a gastroenterologist.

He said that since the tubes are usually indwelling for a several weeks minimum, a lot of inflammatory reaction and scar tissue forms around the puncture sites, particularly in the gastric wall. Toegether with the fact that the puncture wounds are of small caliber, the stomach hole seals quite rapidly. The abdominal wall puncture takes a little longer to fully heal.

Thus it is rare for either a gastro-cutaneous fistula or spillage of gastric contents into the peritoneal cavity to occur upon removal, and in fact complications are rare.

Hope that answers your question.

It did, thank you so much Professor! Sounds like basically the edges of the stomach wall that are around the tube get irritated and swell and when the tube is removed that swelling causes the hole to close up somewhat until it can fully heal. Now I can sleep at night. I hate having a question that I cannot find as answer to!

Shel, looks like you were on the right track girl.