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Case Report
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| Percutaneous endoscopic colostomy for management of pseudo-obstruction | ||||||
| Mirza Faraz Saeed1, Mobeen Ashfaq2, Othman Yousef Alfrayyan3, Amro Salem4 | ||||||
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1MBBS, FMAS, FICS, MS, Registrar General Surgery, Surgery Department, King Hamad University Hospital, Kingdom of Bahrain
2MB Bch BAO, Intern King Hamad University Hospital, Kingdom of Bahrain 3MBBS, Level 3 General Surgery Resident at King Fahad University Hospital, KSA 4MSC, FRCS, Consultant General and Colorectal Surgery, King Hamad University Hospital, Kingdom of Bahrain | ||||||
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| How to cite this article |
| Saeed MF, Ashfaq M, Alfrayyan OY, Salem A. Percutaneous endoscopic colostomy for management of pseudo-obstruction. Int J Case Rep Images 2017;8(5):322–325. |
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ABSTRACT
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Introduction: Percutaneous endoscopic colostomy (PEC) is a minimally invasive variation of percutaneous endoscopic gastrostomy that can be offered to patients who may not be ideal candidates for surgery, or in whom surgery may be inappropriate for other reasons. Case Report: A 61-year-old male with multiple comorbidities, presented with a one-week history of significant diffuse abdominal pain and distention that has been recurrent, associated with anorexia, nausea and chronic constipation. The patient was admitted with the impression of pseudo-obstruction after meticulous clinical examination and imaging (abdominal X-ray and computed tomography scan). During the course of hospital stay, patient refused to undergo the advised surgical procedure and the rectal tube was put in place which failed to relieve the symptoms. Thus, percutaneous endoscopic colostomy (PEC) was performed as per the method first described by Jeffry Ponski in 1986. Colonoscopy showed a partial sigmoid volvulus, for which detorsion was performed to relieve the chronic constipation. Subsequently, the patient was able to receive regular colonic enemas to prevent recurrent obstruction with decrease in abdominal girth with significant deflation and clinical improvement. Conclusion:Percutaneous endoscopic colostomy (PEC) is a promising technique that has shown good results while reducing the surgery burden in selected patients. This patient shows an excellent prognosis at three months follow-up, however more studies are recommended to evaluate the long-term outcomes. Keywords: Colostomy, Endoscopic, Percutaneous, Pseudo-obstruction |
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Author Contributions
Mirza Faraz Saeed – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Mobeen Ashfaq – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Othman Yousef Alfrayyan – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Amro Salem – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2017 Mirza Faraz Saeed et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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