Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction.

Q3 Medicine European journal of case reports in internal medicine Pub Date : 2024-09-24 eCollection Date: 2024-01-01 DOI:10.12890/2024_004872

Jerome Schwingel, Markus Casper, Manfred Lutz

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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.

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经皮内窥镜结肠造口术缓解恶性肠梗阻。

背景：腹膜癌导致的恶性肠梗阻是一个常见问题。当腹腔内肿瘤负荷较高而无法进行手术时，就需要采用其他技术：我们报告了一例升结肠恶性梗阻的 67 岁女性病例。在尝试手术治疗未果后，我们通过经皮内镜结肠造口术，使用腔隙贴合金属支架成功为患者减压。患者在两天内就能恢复完全口服饮食。然而，由于粪便污染了缝线，局部出现了炎症并发症。拆除缝合线后，无需再进行进一步干预：结论：在无法进行手术的情况下，经皮内窥镜结肠造口术是恶性肠梗阻减压的一种安全可行的替代方法。结论：经皮内窥镜结肠造口术是在无法进行手术的情况下，为恶性肠梗阻患者减压的一种安全可行的替代方法，但其局限性包括缝合线导致的局部感染风险，以及仅适用于远端狭窄的病例：恶性肠梗阻是姑息治疗中经常遇到的难题。使用腔隙贴合金属支架（LAMS）进行经皮结肠造口术是一种安全有效的缓解肠梗阻的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European journal of case reports in internal medicine

CiteScore

2.10

自引率

0.00%

发文量

166

审稿时长

8 weeks

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.