Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2007 Apr 21;13(15):2255-7.
doi: 10.3748/wjg.v13.i15.2255.

Severe delayed complication after percutaneous endoscopic colostomy for chronic intestinal pseudo-obstruction: a case report and review of the literature

David Bertolini  1 , Philippe De Saussure, Michael Chilcott, Marc Girardin, Jean-Marc Dumonceau
Affiliations
Review

Severe delayed complication after percutaneous endoscopic colostomy for chronic intestinal pseudo-obstruction: a case report and review of the literature

David Bertolini et al. World J Gastroenterol. .

Abstract

Percutaneous endoscopic colostomy (PEC) is increasingly proposed as an alternative to surgery to treat various disorders, including acute colonic pseudo-obstruction, chronic intestinal pseudo-obstruction and relapsing sigmoid volvulus. We report on a severe complication that occurred two months after PEC placement. A 74-year-old man with a history of chronic intestinal pseudo-obstruction evolving since 8 years was readmitted to our hospital and received PEC to provide long-standing relief. The procedure was uneventful and greatly improved the patient's quality of life. Two months later, the patient developed acute stercoral peritonitis. At laparotomy, the colostomy flange was embedded in the abdominal wall but no pressure necrosis was found at the level of the colonic wall. This complication was likely related to inadvertent traction of the colostomy tube. Subtotal colectomy with terminal ileostomy was performed. We review the major features of 60 cases of PEC reported to date, including indications and complications.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CT-scan showing massive distension of the colon (but not of the small intestine).
Figure 2
Figure 2
Endoscopic view of the left colon. A 19-gauge needle grasped with an endoscopic snare (arrow) serves to hold the colon close to the abdominal wall while a string is passed through a Seldinger needle (arrowhead) to allow for transanal insertion of the colostomy tube.
Figure 3
Figure 3
CT-scan showing the colostomy tube in place (arrow) and a normal-appearing colon.
Figure 4
Figure 4
Abdominal plain X-ray showing a massive pneumoperitoneum.
See this image and copyright information in PMC

References

    1. Connor FL, Di Lorenzo C. Chronic intestinal pseudo-obstruction: assessment and management. Gastroenterology. 2006;130:S29–S36. - PubMed
    1. Di Nardo G, Stanghellini V, Cucchiara S, Barbara G, Pasquinelli G, Santini D, Felicani C, Grazi G, Pinna AD, Cogliandro R, et al. Enteric neuropathology of congenital intestinal obstruction: A case report. World J Gastroenterol. 2006;12:5229–5233. - PMC - PubMed
    1. Stanghellini V, Cogliandro RF, De Giorgio R, Barbara G, Morselli-Labate AM, Cogliandro L, Corinaldesi R. Natural history of chronic idiopathic intestinal pseudo-obstruction in adults: a single center study. Clin Gastroenterol Hepatol. 2005;3:449–458. - PubMed
    1. Thompson AR, Pearson T, Ellul J, Simson JN. Percutaneous endoscopic colostomy in patients with chronic intestinal pseudo-obstruction. Gastrointest Endosc. 2004;59:113–115. - PubMed
    1. Soudah HC, Hasler WL, Owyang C. Effect of octreotide on intestinal motility and bacterial overgrowth in scleroderma. N Engl J Med. 1991;325:1461–1467. - PubMed