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. 2024 Sep 24;11(10):004872.
doi: 10.12890/2024_004872. eCollection 2024.

Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction

Jerome Schwingel  1 , Markus Casper  1 , Manfred Lutz  1
Affiliations

Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction

Jerome Schwingel et al. Eur J Case Rep Intern Med. .

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.

Keywords: Bowel obstruction; peritoneal carcinomatosis.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
(A) Endoscopic view of the fully deployed LAMS in the caecum and (B) external view of the LAMS with four sutures in place.
See this image and copyright information in PMC

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