| Endoscopic-assisted Colopexy and Push Percutaneous Colostomy in the Transverse Colon for Refractory Chronic Intestinal pseudo-Obstruction. | |
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MedLine Citation:
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PMID: 22146183 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Percutaneous endoscopic colostomy (PEC), using the classic pull-through technique in the ascending or the descending colon, has been proven useful to treat chronic intestinal pseudo-obstruction. We report the case of a high-surgical risk 70-year-old male with refractory chronic intestinal pseudo-obstruction, in whom the ascending colon could not be reached due to tortuous left dolichocolon. Endoscopic-assisted colopexy and push colostomy in the proximal transverse colon was decided accordingly. Colopexy was performed under direct endoscopic vision in the proximal transverse colon using 3 preloaded T-fasteners surrounding the intended stoma site. The stoma tract was created with an introducer needle, allowing the advance of the 24 Fr 4-sleeve dilator over a guidewire. Afterwards, the dilator was removed and the peel-away sheath was left in place. Over the guidewire, a 20-Fr gastrostomy tube was advanced into the colon lumen through the covering, which was finally removed. The patient recovered uneventfully, despite postprocedure pneumoperitoneum, which was related to the technique. He died a month later due to unrelated comorbidities, without further abdominal complaints after discharge. This is the first report of PEC both using a push technique, and the first report in a different location than the ascending or the descending colon. We believe this novel push technique may be feasible for PEC, avoiding the need of reinsertion in patients with difficult colonoscopy. |
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Authors:
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Javier Molina-Infante; Jose M Mateos-Rodriguez; Gema Vinagre-Rodriguez; Elisa Martin-Noguerol; Jesus M Gonzalez Santiago |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgical laparoscopy, endoscopy & percutaneous techniques Volume: 21 ISSN: 1534-4908 ISO Abbreviation: Surg Laparosc Endosc Percutan Tech Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100888751 Medline TA: Surg Laparosc Endosc Percutan Tech Country: United States |
Other Details:
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Languages: eng Pagination: e322-5 Citation Subset: IM |
Affiliation:
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Unit of Gastroenterology, Hospital San Pedro de Alcántara, Caceres, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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