transgastric diversion of transnasal long tube placement using a percutaneous endoscopic gastrostomy site in a patient with bowel obstruction and massive ascites due to ovarian carcinoma

The course of patients with advanced ovarian carcinoma is often complicated by bowel obstruction and/or massive ascites. A transnasal long tube may be placed to relieve bowel obstruction, but produces nasal discomfort and pain. Recently, the effectiveness of percutaneous endoscopic gastrostomy (PEG) tube placement for malignant bowel obstruction due to ovarian carcinoma has been reported, but not all patients received effective decompression. Diversion of a transnasal long tube to the PEG site in this case provided a useful method of long-term decompression while providing improved quality of life.