Placement of a colonic stent by percutaneous colostomy in a case of malignant stenosis

• Published in: Cardiovascular and interventional radiology Vol. 24; no. 1; pp. 67 - 69
• Main Authors: GOMEZ HERRERO, Helena, DIAZ, Laura Paul, PINTO PABON, Isabel, LOBATO FERNANDEZ, Rosa
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01-01-2001; Berlin Springer Nature B.V
• Subjects: Biological and medical sciences; Cancer; Colonic Diseases - etiology; Colonic Diseases - surgery; Colostomy - methods; Constriction, Pathologic - etiology; Constriction, Pathologic - surgery; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - surgery; LARGE INTESTINE; Male; Medical sciences; Middle Aged; NEOPLASMS; PATIENTS; RADIOLOGY AND NUCLEAR MEDICINE; Stents; STOMACH; Stomach Neoplasms - complications; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; SYMPTOMS; THERAPY; Tumors; Human; Endoprosthesis; Carcinoma; Instrumentation therapy; Stenosis; Colostomy; Instrumental dilatation; Malignant tumor; Percutaneous route; Colonic disease; Case study; Treatment; Digestive diseases; Intestinal disease; Complication; Colon; Technique
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s002700001726

We present a patient with disseminated stomach cancer who presented with symptoms of acute obstruction of the splenic flexure of the colon caused by tumor spread. During a first attempt to insert a colon stent through the anus under endoscopic guidance as final palliative therapy, it was not possible to reach the region of the stricture, and iatrogenic perforation of the descending colon occurred, which resolved favorably under conservative management. A second attempt to insert a stent was made via percutaneous puncture of the transverse colon, approaching the region of the stricture by a descending route. The procedure was completed without complications and the patient's symptoms improved. Stent placement via percutaneous puncture of the colon has not previously been described in the literature. It may be an alternate route in cases of proximal strictures in which access through the anus has been unsuccessful even with the aid of endoscopic guidance.