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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(03): E289-E291
DOI: 10.1055/a-1336-2213
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Endoscopic ultrasound-guided colo-colostomy in a case of acute large bowel obstruction

James Emmanuel
Department of Gastroenterology and Hepatology, Selayang Hospital, Selangor, Malaysia
,
Sattian Kollanthavelu
Department of Gastroenterology and Hepatology, Selayang Hospital, Selangor, Malaysia
,
Fitjerald Henry
Department of Gastroenterology and Hepatology, Selayang Hospital, Selangor, Malaysia
,
Lee Tiong See
Department of Gastroenterology and Hepatology, Selayang Hospital, Selangor, Malaysia
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Abstract

Bowel obstruction is one of the most common surgical emergencies and a major cause of morbidity and mortality. Standard supportive measures must be instituted as soon as the diagnosis is confirmed. Anastomotic strictures are a benign etiology of intestinal obstruction, occurring in up to 22 % of patients following colorectal resection. Traditionally, endoscopic balloon dilation (EBD) has been the intervention of choice in such cases; however, it may not be feasible in all settings. We report a novel application of the AXIOS stent and electrocautery-enhanced delivery system (Boston Scientific, Marlborough, Massachusetts, United States) to create a colo-colostomy to bypass a sigmoid colon stricture in a 51-year-old woman who presented with acute intestinal obstruction. Despite stent dislodgment during the procedure, the preexisting tract allowed us to improvise our technique with a second LAMS placement. The patient was discharged well 48 hours after the procedure. However, 4 months later, she required a session of EBD following a presentation for fecal impaction. She is currently asymptomatic and being followed up regularly as an outpatient.



Publication History

Received: 29 April 2020

Accepted: 02 November 2020

Article published online:
18 February 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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