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EUS-guided colo-enterostomy as a salvage drainage procedure in a high surgical risk patient with small bowel obstruction due to severe ileocolonic anastomotic stricture: a new application of lumen-apposing metal stent (LAMS)

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Abstract

We submit the first case report of a successful EUS-guided transmural LAMS placement to drain the small bowel directly into the transverse colon in a high surgical risk patient with obstruction due to severe anastomotic stricture. We describe our technique for endoscopic colo-enterostomy and are hopeful that this will become a viable option to manage non-operable high-grade distal small bowel obstruction.

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Abbreviations

LAMS:

Lumen apposing metal stent

EUS:

Endoscopic ultrasound

SBO:

Small bowel obstruction

KUB:

Kidney ureter bladder X-ray

FOLFOX:

Folinic acid, fluorouracil, oxaliplatin chemotherapy regimen

HIPEC:

Hyperthermic intraperitoneal chemotherapy

NGT:

Nasogastric tube

TPN:

Total parenteral nutrition

CT:

Computerized topograpghy

G:

Gauge

FNA:

Fine-needle aspiration

FNB:

Fine-needle biopsy

LUQ:

Left upper quadrant

FDA:

Food and Drug Administration

CBD:

Common bile duct

ERCP:

Endoscopic retrograde cholangiopancreatography

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Acknowledgements

The authors thank the dedicated work of our endoscopy staff involved in this case: Tiffany C Brown, Shawn A Benton, Julmer Canizares RN, and Belinda M Mason RN, as well as the assistance of Earl Cassidy, Senior Territory Manager of Boston Scientific.

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Authors and Affiliations

  1. Director of EUS and Bariatric Endoscopy, Sinai Hospital, LifeBridge Health, Baltimore, MD, USA

    Hugh D. Mai

  2. Gastroenterology, Sinai Hospital, LifeBridge Health, Baltimore, MD, USA

    Ethan Dubin

  3. Surgical Oncology, Sinai Hospital, LifeBridge Health, Baltimore, MD, USA

    Arun A. Mavanur

  4. Chief Medical Oncology, Sinai Hospital, LifeBridge Health, Baltimore, MD, USA

    Marvin Feldman

  5. Chief Gastroenterology Division, Sinai Hospital, LifeBridge Health, Baltimore, MD, USA

    Sudhir Dutta

  6. School of Medicine, University of Maryland, Baltimore, MD, USA

    Sudhir Dutta

Authors
  1. Hugh D. Mai
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  2. Ethan Dubin
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  3. Arun A. Mavanur
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  4. Marvin Feldman
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  5. Sudhir Dutta
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Corresponding author

Correspondence to Hugh D. Mai.

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All authors declared no financial relationships and no conflict of interest relevant to this publication.

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Mai, H.D., Dubin, E., Mavanur, A.A. et al. EUS-guided colo-enterostomy as a salvage drainage procedure in a high surgical risk patient with small bowel obstruction due to severe ileocolonic anastomotic stricture: a new application of lumen-apposing metal stent (LAMS). Clin J Gastroenterol 11, 282–285 (2018). https://doi.org/10.1007/s12328-018-0837-5

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  • DOI: https://doi.org/10.1007/s12328-018-0837-5

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