Palliative treatment of malignant intestinal obstruction with EUS-guided ileosigmoidostomy – a case report

Abstract

We present the case of a 70-year-old patient of Caucasian origin under palliative chemotherapy for metastasized colorectal cancer, who presented with signs of complete small bowel obstruction six months after placement of a diverting ileostomy. Following previous tumor perforation, he was not considered a candidate for further surgical intervention.

Thus, endoscopic ultrasound-guided enterocolostomy (i.e., ileosigmoidostomy) with a lumen-apposing metal stent was successfully performed in a coloenteric approach to restore the passage.

Oral nutrition could be resumed the next day, and the patient could be discharged in substantially improved condition after three days.

Zusammenfassung

Wir beschreiben den Fall eines 70-jährigen kaukasischen Patienten unter palliativer Chemotherapie eines metastasierten kolorektalen Karzinoms, der sich sechs Monate nach Anlage eines doppelläufigen Ileostomas mit dem Bild eines mechanischen Dünndarmileus vorstellte. Aufgrund einer früheren Tumorperforation wurde eine erneute chirurgische Intervention nicht als sinnvoll erachtet.

Wir führten daher in einem koloenterischen Vorgehen eine enodosonografisch geführte Enterokolostomie (hier: Ileosigmoidostomie) mit einem „lumen-apposing metal stent“ durch, um die Passage wiederherzustellen.

Der Patient konnte sich ab dem Folgetag wieder oral ernähren und wurde nach drei Tagen in deutlich gebessertem Zustand entlassen.

Keywords

endoscopy - endoscopic ultrasound - oncology

Schlüsselwörter

Endoskopie - Onkologie - Endosonografie

Publikationsverlauf

Eingereicht: 09. September 2024

Artikel online veröffentlicht:
25. November 2024

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