[Palliative Interventional Radiology for Malignant Bowel Obstruction]

In interventional radiology (IR) for malignant bowel obstruction, treatment is broadly classified into drainage and stent placement. In cases such as terminal-stage malignancy, where removal of a nasogastric or ileus tube is unlikely, gastrostomy or stent placement may be performed endoscopically. However, for patients in whom endoscopic gastrostomy is difficult-such as those with anatomical or procedural limitations-IR-guided access for gastrointestinal decompression can be considered. Representative procedures include percutaneous radiologic gastrostomy (PRG), also referred to as radiologically inserted gastrostomy (RIG), and percutaneous transesophageal gastro-tubing (PTEG). In specific cases such as afferent loop syndrome, stent placement through a percutaneous transhepatic biliary drainage (PTBD) route may also be utilized. These IR procedures are generally performed under local anesthesia and are relatively minimally invasive, making them a viable option in palliative care.