ENDOSCOPIC ULTRASOUND (EUS) GUIDED COLORECTAL ANASTOMOSIS FOR SUCCESSFUL RELIEF OF MALIGNANT ADHESIVE LEFT SIDED COLONIC OBSTRUCTION IN A CASE OF FAILED COLONIC STENTING

53-y-female,Primary Peritoneal Carcinomatosis–sigmoid colectomy(2017),right hemi-colectomy(2020) for tumour de-bulking and relief of recurrent obstruction,multiple chemotherapy cycles. Complaints–distal large bowel obstruction at rectosigmoid-peritoneal adhesions, CECT–dilated large colon,adhesive obstruction at rectosigmoid–failed colonic stenting due to sharp angulation & failed guidewire cannulation. Linear EUS and fluoroscopy–apposed dilated colonic segment. Contrast injected into obstructed bowel-19G needle. Colorectal anastomosis using hot lumen apposing metal stent(LAMS;20mmX10mm). 7Fr catheter through LAMS for saline irrigation,lactulose enema. Immediate decompression with symptomatic relief. X-ray–significant decompression. Oral diet resumed after 2 days.Sigmoidoscopy after 72hours–LAMS in situ,draining faeces, irrigation catheter removed.Discharged 3 days later.No complications.Asymptomatic-3-weeks f/u.

Publication History

Article published online:
14 April 2022