An 86-year-old woman with gastrostomy tube feeding occasionally vomited and complained of stomach tenderness after her family doctor replaced the tube. Imaging research showed the end of the gastrostomy tube with the balloon experienced migrated into the second part of the duodenum. They diagnosed acute cholangitis and pancreatitis secondary to duodenal obstruction. Her family doctor might have inserted the tube too deeply. After the tube was changed, her symptoms immediately improved. Five cases of acute pancreatitis linked to gastrostomy tube migration have been reported. Dr. Imamura experienced a very rare complication of gastrostomy tube, which case demonstrated a malpositioned gastrostomy tube can be an iatrogenic reason behind acute pancreatitis and cholangitis..Independent, Retrospective Stanford Study To provide an unbiased assessment of DA-EPOCH-R, we collaborated with investigators at Stanford University INFIRMARY who had begun to use DA-EPOCH-R in 2007 to take care of primary mediastinal B-cell lymphoma.21 They reviewed all charts from 2007 through 2012 and found 16 previously untreated patients who had been consecutively treated with DA-EPOCH-R; non-e needed radiotherapy.