Percutaneous Endoscopic Colostomy to Relieve Malignant Bowel Obstruction

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Palliative Care

Background:

• Malignant bowel obstruction from peritoneal carcinomatosis presents a significant challenge.
• Surgical intervention may not be feasible due to high tumor burden.

Purpose of the Study:

• To evaluate the efficacy of percutaneous endoscopic colostomy with a lumen-apposing metal stent (LAMS) for malignant bowel obstruction.
• To present a case study of successful decompression in a patient with unresectable disease.

Main Methods:

• A case report of a 67-year-old female with malignant ascending colon obstruction.
• Percutaneous endoscopic colostomy using a LAMS following an unsuccessful surgical attempt.
• Management of local inflammatory complications.

Main Results:

• Successful decompression of malignant bowel obstruction was achieved via percutaneous endoscopic colostomy with a LAMS.
• The patient resumed oral intake within 2 days.
• Local inflammatory complications due to suture contamination were managed conservatively after suture removal.

Conclusions:

• Percutaneous endoscopic colostomy with LAMS is a safe and viable alternative for bowel decompression when surgery is contraindicated.
• Potential limitations include risks of local infection and applicability in distal obstructions.
• This technique provides long-term patency and is effective in palliative care settings.