| Summary: | Chilaiditi syndrome is an occasional radiographic anomaly characterized by the interposition of the bowels between the liver and the diaphragm. The presence of Chilaiditi syndrome can cause serious problem on percutaneous endoscopic gastrostomy (PEG) procedure, because the anomalous position of the transverse colon can obstruct the procedure and might lead to occurrence of complications. Our report describes a PEG-induced gastro-colo-cutaneous fistula in a patient with Chilaiditi syndrome which resulted in minimally invasive laparoscopic gastrostomy. As most patients who need a PEG placement have impaired consciousness, the majority of PEG-related complications are overlooked or discovered long after the procedure. However, we recognized the complication immediately after the PEG procedure and successfully treated by laparoscopic surgery.
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