Schwingel Jerome, Casper Markus, Lutz Manfred
Department of Internal Medicine and Gastroenterology, Caritasklinikum Saarbrücken St. Theresia, Saarbrücken, Germany.
Eur J Case Rep Intern Med. 2024 Sep 24;11(10):004872. doi: 10.12890/2024_004872. eCollection 2024.
Malignant bowel obstruction due to peritoneal carcinomatosis is a common problem. When surgery is not feasible in the context of a high intraperitoneal tumour burden, other techniques are required.
We report the case of a 67-year-old female with malignant obstruction of the ascending colon. Following an unsuccessful surgical attempt, decompression was successfully achieved via percutaneous endoscopic colostomy using a lumen-apposing metal stent. The patient was able to resume a full oral diet within 2 days. However, local inflammatory complications arose due to faecal contamination of the sutures. Once the sutures were removed, no further interventions were required.
Percutaneous endoscopic colostomy is a safe and viable alternative for decompression in malignant bowel obstruction when surgery is not feasible. However, limitations include the risk of local infection due to sutures and its applicability only in cases with distal stenosis.
Malignant bowel obstruction is a frequent challenge in palliative care.Percutaneous colostomy with a lumen-apposing metal stent (LAMS) is a safe and effective option to relieve bowel obstruction.Percutaneous colostomy with a LAMS remains patent in the long term.
腹膜癌病所致恶性肠梗阻是一个常见问题。当腹腔内肿瘤负荷较高而无法进行手术时，需要其他技术。
我们报告一例67岁女性升结肠癌恶性梗阻病例。手术尝试失败后，通过使用管腔对接金属支架的经皮内镜结肠造口术成功实现减压。患者在2天内能够恢复正常经口饮食。然而，由于缝线被粪便污染出现了局部炎症并发症。缝线拆除后，无需进一步干预。
当手术不可行时，经皮内镜结肠造口术是恶性肠梗阻减压的一种安全可行的替代方法。然而，局限性包括缝线导致局部感染的风险以及仅适用于远端狭窄的病例。
恶性肠梗阻是姑息治疗中常见的挑战。使用管腔对接金属支架（LAMS）的经皮结肠造口术是缓解肠梗阻的一种安全有效的选择。使用LAMS的经皮结肠造口术长期保持通畅。
