Palliation of malignant distal colonic obstruction via percutaneous endoscopic colostomy using a lumen-apposing metal stent

Abstract

Video 1Palliation of malignant distal colonic obstruction via a percutaneous endoscopic colostomy using a lumen-apposing metal stent.

Keywords: LAMS, lumen-apposing metal stent.

Figure 1

CT sagittal view demonstrating inadequate stent expansion with a 90-degree posterior kink at the junction of the superior and inferior stents.

Figure 2

CT sagittal (left) and axial (right) views on admission demonstrating signs of large-bowel obstruction.

Figure 3

Placement of external T-tags in the transverse colon.

Figure 4

Advancement of a lumen-apposing metal stent into the colon under direct endoscopic visualization.

Figure 5

Endoscopic deployment of internal flange with withdrawal from the external side to allow apposition to the colonic wall.

Figure 6

Deployed stent with balloon dilation catheter within the stent lumen.

Figure 7

Fluoroscopic view of colonoscope in the right colon segment and deployment of stent across the colostomy tract.

Figure 8

Image taken with the endoscope showing esophageal stent placed in the ostomy track at the time of transostomy EUS-guided ileocolonic anastomosis for subsequent small-bowel obstruction.

Figure 9

CT imaging sagittal (left) and axial (right) views after the procedure in which the lumen-apposing metal stent can be seen.