{"title":"Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction.","authors":"Jerome Schwingel, Markus Casper, Manfred Lutz","doi":"10.12890/2024_004872","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Malignant bowel obstruction due to peritoneal carcinomatosis is a common problem. When surgery is not feasible in the context of a high intraperitoneal tumour burden, other techniques are required.</p><p><strong>Case report: </strong>We report the case of a 67-year-old female with malignant obstruction of the ascending colon. Following an unsuccessful surgical attempt, decompression was successfully achieved via percutaneous endoscopic colostomy using a lumen-apposing metal stent. The patient was able to resume a full oral diet within 2 days. However, local inflammatory complications arose due to faecal contamination of the sutures. Once the sutures were removed, no further interventions were required.</p><p><strong>Conclusion: </strong>Percutaneous endoscopic colostomy is a safe and viable alternative for decompression in malignant bowel obstruction when surgery is not feasible. However, limitations include the risk of local infection due to sutures and its applicability only in cases with distal stenosis.</p><p><strong>Learning points: </strong>Malignant bowel obstruction is a frequent challenge in palliative care.Percutaneous colostomy with a lumen-apposing metal stent (LAMS) is a safe and effective option to relieve bowel obstruction.Percutaneous colostomy with a LAMS remains patent in the long term.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451855/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of case reports in internal medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12890/2024_004872","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Malignant bowel obstruction due to peritoneal carcinomatosis is a common problem. When surgery is not feasible in the context of a high intraperitoneal tumour burden, other techniques are required.
Case report: We report the case of a 67-year-old female with malignant obstruction of the ascending colon. Following an unsuccessful surgical attempt, decompression was successfully achieved via percutaneous endoscopic colostomy using a lumen-apposing metal stent. The patient was able to resume a full oral diet within 2 days. However, local inflammatory complications arose due to faecal contamination of the sutures. Once the sutures were removed, no further interventions were required.
Conclusion: Percutaneous endoscopic colostomy is a safe and viable alternative for decompression in malignant bowel obstruction when surgery is not feasible. However, limitations include the risk of local infection due to sutures and its applicability only in cases with distal stenosis.
Learning points: Malignant bowel obstruction is a frequent challenge in palliative care.Percutaneous colostomy with a lumen-apposing metal stent (LAMS) is a safe and effective option to relieve bowel obstruction.Percutaneous colostomy with a LAMS remains patent in the long term.
期刊介绍：
The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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