What is the incidence of colocutaneous fistula with PEG tube placement?

• A. 0-0.27% of cases
• B. 1-2% of cases
• C. 0.3-2.5% of cases
• D. 5-10% of cases

Answer: (A)

Colocutaneous fistula after a percutaneous endoscopic gastrostomy is a very rare complication. It occurs when a tract forms between the colon and the skin at the PEG site, which can happen if the colon lies between the stomach and the abdominal wall during placement or, less often, due to delayed erosion or movement of the tube. Because this event is so uncommon, the observed incidence is extremely low—typically described as a fraction of a percent and often reported as near zero to well under 1%. That’s why the best answer reflects a barely perceptible risk rather than a more frequent complication. In contrast, the higher percentage options would imply a much more common problem, which isn’t supported by most clinical data. If this complication does occur, management focuses on addressing the fistula, which may involve removing the PEG and repairing the tract, with careful follow-up to ensure healing.