Successful management of splenic perforation during percutaneous endoscopic gastrostomy tube placement in a cat via laparoscopic partial splenectomy

Case summary A 12-year-old spayed female domestic shorthair cat with a weight of 4.5 kg and a body condition score of 3/9 presented with anorexia and vomiting. Feline hepatic lipidosis was diagnosed based on blood tests and ultrasound examination. Naso-oesophageal tube feeding was initiated, but hypersalivation persisted despite supportive care. As a result of poor feeding tolerance, a percutaneous endoscopic gastrostomy (PEG) tube was placed for long-term enteral nutrition, with endoscopic confirmation of gastric placement. Two hours after the procedure, blood staining on the PEG tube bandage suggested bleeding at the insertion site. Abdominal ultrasonography and CT revealed splenic perforation. A laparoscopic partial splenectomy was performed successfully and the cat recovered without complications. Follow-up laboratory tests demonstrated a gradual improvement in haematological parameters, including haematocrit and total bilirubin. The cat remained clinically stable without further complications.Relevance and novel information This report details the first documented case of splenic perforation during PEG tube placement in a cat, successfully managed through laparoscopic partial splenectomy. Minimally invasive laparoscopy has demonstrated efficacy in addressing rare complications, including splenic perforation associated with PEG tube placement in cats.