Case StudyPercutaneous endoscopic cecostomy in adults: a case series
Section snippets
Patients and methods
Seven patients underwent 8 PEC placements between May 2001 and October 2005: 5 patients for recurrent colonic pseudoobstruction and 2 with chronic refractory constipation. One patient with recurrent pseudoobstruction underwent PEC placement twice. The PEC procedure was similar to that described for the PEG pull technique14 as modified by Ponsky et al.7 For patients with refractory constipation, a 2-day preparation of the colon was performed. On day 1, the patients ingested only clear liquids.
Observations
PEC placement was successful in 8 of 8 attempts (6 men, 2 women) (Table 1). One patient with recurrent pseudoobstruction underwent PEC placement twice, the second was placed for symptom recurrence 17 months after having the first one removed for stable clinical improvement.
Procedure duration averaged 71 minutes (range, 37-120 minutes; median, 70 minutes). Two cases were performed on an outpatient basis. Five patients were discharged 2 days after PEC placement, and 1 inpatient remained in the
Discussion
To our knowledge, our retrospective case series represents the largest series to date describing experience with PEC in adults with colonic pseudoobstruction or chronic constipation. Ponsky et al7 first described its use in 1986 in 2 patients with ACPO who were unsuccessfully treated with colonoscopic decompression. In both cases, PEC successfully and rapidly led to colonic decompression without complications. Salm et al8 reported 2 cases of uncomplicated PEC used for venting in adult patients
References (18)
- et al.
Preliminary report: the antegrade continence enema
Lancet
(1990) - et al.
The cecostomy button
J Pediatr Surg
(1997) - et al.
Simplified technique for antegrade continence enemas for fecal retention and incontinence
J Am Coll Surg
(1998) - et al.
Percutaneous endoscopic cecostomy: a new approach to nonobstructive colonic dilation
Gastrointest Endosc
(1986) - et al.
Percutaneous endoscopic cecostomy: a case series
Gastrointest Endosc
(2003) - et al.
Percutaneous colonoscopic cecostomy for management of chronic constipation in children
Gastrointest Endosc
(2001) - et al.
Percutaneous endoscopic cecostomy for management of refractory constipation in an adult patient
Gastrointest Endosc
(2003) - et al.
Percutaneous endoscopic gastrostomy: a nonoperative technique for feeding gastrostomy
Gastrointest Endosc
(1981) - et al.
Cecostomy. Therapeutic indications and results
Dis Colon Rectum
(1995)
Cited by (55)
Percutaneous Cecostomy in Adult Patients: Safety and Quality-of-Life Results
2015, Journal of Vascular and Interventional RadiologyCitation Excerpt :Endoscopic placement of cecostomies in adult patients has also shown similar outcomes to our cohort. Lynch et al (9) reported using percutaneous endoscopic cecostomy in eight adult patients, six with colonic pseudo-obstruction and two with chronic constipation. Seven of their eight procedures were technically successful and resulted in clinical improvement.
Angiography and Interventional Radiology of the Hollow Viscera
2014, Textbook of Gastrointestinal Radiology: Volumes 1-2, Fourth EditionCritical Care and Emergency Surgery
2023, Higher FRCS: SBAs for Section 1 of the General Surgery FRCS ExaminationTherapeutic utility of percutaneous cecostomy in adults: an updated systematic review
2022, Therapeutic Advances in Gastrointestinal Endoscopy
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See CME section; p. 243.