Acute surgical abdomen in an immunocompromised patient

direct vision with 0 vicryl. Skin was opposed with a single interrupted suture (to minimize wound complications). A PEG tube was placed through the 5 mL port site to decompress the stomach and act as a gastropexy. Unfortunately, during positioning of the PEG, the most inferior gastroplasty stitch cut-out. However, this did not seem to compromise the repair. The patient’s symptoms resolved immediately and remained that way at 6-week review (see Fig. 1). The wrap remained snug and the PEG was carefully removed with no wound complications. This technique can be considered as a minimally invasive approach to technically simple intra-gastric procedures where upper abdominal adhesions and co-morbidities would make other approaches potentially hazardous. An abdominal computed tomography with gastric protocol (or simply distending the stomach with air) is a valuable tool to determine if the procedure is feasible. Paul Conaglen,*† MBChB Greg Emery,‡ MBBS, FANZCA Gavin Wright,§¶ MBBS, FRACS *Thoracic Surgery, St Vincent’s and Mercy Private Hospital, Departments of †Cardiothoracic Surgery, ‡Anaesthesia, and §Surgical Oncology, St Vincent’s Hospital, and ¶Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia