Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 21, 2007; 13(15): 2255-2257
Published online Apr 21, 2007. doi: 10.3748/wjg.v13.i15.2255
Severe delayed complication after percutaneous endoscopic colostomy for chronic intestinal pseudo-obstruction: A case report and review of the literature
David Bertolini, Philippe De Saussure, Michael Chilcott, Marc Girardin, Jean-Marc Dumonceau
David Bertolini, Philippe De Saussure, Marc Girardin, Jean-Marc Dumonceau, Divisions of Gastroenterology and Hepatology, Geneva University Hospitals, Geneva, Switzerland
Michael Chilcott, Department of Digestive Surgery, Geneva University Hospitals, Geneva, Switzerland
Author contributions: All authors contributed equally to the work.
Correspondence to: Jean-Marc Dumonceau, MD, PhD, Divisions of Gastroenterology and Hepatology, Geneva University Hospitals, Micheli-du-Crest street, 24, 1205 Geneva, Switzerland. jmdumonceau@hotmail.com
Telephone: +41-22-3729340 Fax: +41-22-3729366
Received: February 8, 2007
Revised: February 24, 2006
Accepted: March 8, 2007
Published online: April 21, 2007
Abstract

Percutaneous endoscopic colostomy (PEC) is increasingly proposed as an alternative to surgery to treat various disorders, including acute colonic pseudo-obstruction, chronic intestinal pseudo-obstruction and relapsing sigmoid volvulus. We report on a severe complication that occurred two months after PEC placement. A 74-year-old man with a history of chronic intestinal pseudo-obstruction evolving since 8 years was readmitted to our hospital and received PEC to provide long-standing relief. The procedure was uneventful and greatly improved the patient’s quality of life. Two months later, the patient developed acute stercoral peritonitis. At laparotomy, the colostomy flange was embedded in the abdominal wall but no pressure necrosis was found at the level of the colonic wall. This complication was likely related to inadvertent traction of the colostomy tube. Subtotal colectomy with terminal ileostomy was performed. We review the major features of 60 cases of PEC reported to date, including indications and complications.

Keywords: Percutaneous endoscopic colostomy; Complications; Colonic pseudo-obstruction; Ileus; Peritonitis