Case Series
Volume 14 Issue 8 - 2022
Bezoar and Catheter Knotting as Complications of Levodopa Carbidopa Intestinal Gel Therapy
Tuğçe Saltoğlu1*, Zeynep Büyükorhan1, Ömer Öztürk2 and Yeşim Sücüllü Karadağ1
1Department of Neurology, Movement Disorders Clinic, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
2Department of Gastroenterology, Ankara City Hospital, Ankara, Turkey
*Corresponding Author: Tuğçe Saltoğlu, Department of Neurology, Movement Disorders Clinic, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
Received: July 23, 2022; Published: July 29, 2022


Parkinson’s disease (PD) is an insidious, slowly progressing neurodegenerative disease affecting the nigrostriatal pathway in the brain. Levodopa-carbidopa intestinal gel (LCIG) is one of the best device-assisted therapies used in advanced-stage Parkinson’s disease. The crucial complications of this treatment are rare and mostly due to percutaneous gastrostomy. This manuscript presents two rare catheter complications of percutaneous gastrostomy with levodopa-carbidopa intestinal gel therapy.

Keywords: Advanced Stage Parkinson’s Disease; LCIG; Device-Assisted Therapy


  1. Mhyre TR., et al. “Parkinson’s disease”. Subcellular Biochemistry 65 (2013): 389-455.
  2. Hayes MT. “Parkinson’s Disease and Parkinsonism”. American Journal of Medicine 132 (2019): 802-807.
  3. Esmail S. “The Diagnosis and Management of Parkinson’s Disease Article Information”. Scholar Journal of Applied Sciences and Research 1 (2018).
  4. Luquin M-R., et al. “Consensus on the Definition of Advanced Parkinson’s Disease: A Neurologists-Based Delphi Study (CEPA Study)”. Teive H, editor. Park District (2017): 4047392.
  5. Timpka J., et al. “Device-Aided Treatment Strategies in Advanced Parkinson’s Disease”. International Review of Neurobiology 132 (2017): 453-474.
  6. Cerrone P., et al. “Phytobezoar and duodenal ulcer as complication of Duodopa therapy in a patient affected by Parkinson’s disease”. BMJ Case Reports (2018): bcr-2017-223884.
  7. Aradi SD and Hauser RA. “Medical Management and Prevention of Motor Complications in Parkinson’s Disease”. Neurotherapeutics4 (2020): 1339-1365.
  8. Skodda S. “Profile of levodopa/carbidopa intestinal gel and its potential in the treatment of advanced Parkinson and #39;s disease”. Restless Legs Syndrome and Parkinson Disease (2014).
  9. Sücüllü Karadağ Y., et al. “Comprehensive assessment of levodopa-carbidopa intestinal gel for turkish advanced parkinson’s disease patients”. Turkish Journal of Medical Sciences 1 (2021): 84-89.
  10. Paschos KA and Chatzigeorgiadis A. “Pathophysiological and clinical aspects of the diagnosis and treatment of bezoars”. Annals of Gastroenterology 3 (2019): 224-232.
  11. Poirier A-A., et al. “Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments. Wu S-L, editor”. Park District (2016): 6762528.
  12. Abu-Heija AA., et al. “Delayed Diagnosis of Buried Bumper Syndrome When Only the Jejunostomy Extension is Used in a Percutaneous Endoscopic Gastrostomy-jejunostomy Levodopa-carbidopa Intestinal Gel Delivery System”. Cureus 4 (2019): e4568-e4568.
  13. Stathis P., et al. “Gastric bezoar complication of Duodopa® therapy in Parkinson’s disease, treated with Coca-Cola®”. Movement Disorders 8 (2014): 1087-1088.
  14. Taki S., et al. “Migration of a percutaneous endoscopic gastrojejunostomy tube into the colon with small intestinal telescoping”. Clinical Endoscopy 6 (2019): 616-619.
  15. Krones E., et al. “Knotting of percutaneous endoscopic jejunostomy feeding tubes in two patients with Parkinsons disease and continuous Duodopa ® treatment”. Zeitschrift für Gastroenterologie 2 (2012): 213-216.
  16. Udd M., et al. “Problems related to levodopa-carbidopa intestinal gel treatment in advanced Parkinson’s disease”. Brain and Behavior 7 (2017): 1-7.
  17. Nyholm D and Lennernäs H. “Irregular gastrointestinal drug absorption in Parkinson's disease”. Expert Opinion on Drug Metabolism and Toxicology 2 (2008): 193-203.
  18. Del-Hoyo-Francisco J., et al. “Knotting of Duodopa® duodenal infusion system”. Revista Espanola de Enfermedades Digestivas5 (2015): 323-324.
Citation: Tuğçe Saltoğlu., et al. “Bezoar and Catheter Knotting as Complications of Levodopa Carbidopa Intestinal Gel Therapy”. EC Neurology 14.8 (2022): 38-41.

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