Percutaneous cecostomy is an uncommon procedure but is reported as an effective temporising measure to achieve acute decompression of bowel obstruction. It has been reported as a safe procedure in the setting of bowel obstruction providing relief of symptoms. The insertion of a cecostomy in the distal colon is not routinely advised as it will not allow passage of formed faeces. Cases of antegrade stenting of proximal colonic obstruction via cecostomy have been described; however, antegrade stenting of the distal colon from access in the ascending colon can be technically challenging. We describe a case of a percutaneous colostomy inserted temporally at the splenic flexure, which provided close access to an obstructing descending colonic tumour, allowing definitive management with placement of a colonic stent. This technical feasibility case provides evidence that a temporary cecostomy placed in the distal colon can be performed as a measure to facilitate definitive management.
Cecostomy ; Colon* ; Colon, Ascending ; Colon, Descending ; Colon, Transverse ; Colostomy ; Decompression ; Stents*

Cecal volvulus is a rare disease of the colon, which occurs in less than 2% of adult intestinal obstruction cases. Precipitating factors can be identified in some patients, including adhesions, a recent abdominal operation, congenital bands, pregnancy, violent exercise, malrotation, obstructing lesions of the left colon and colonoscopy, etc. A right colectomy is a definitive treatment for the best long term control of symptoms, and is the treatment of choice when gangrenous changes are present in the bowel. However, in the presence of viable bowel, the preferred treatment is a controversial matter, with options including; detorsion, cecopexy and cecostomy, etc. We experienced a case of cecal vovulus, which had been treated for COPD at ICU. A diagnosis was made with abdominal computed tomography, and a right hemicolectomy was performed.
Adult ; Cecostomy ; Colectomy ; Colon ; Colonoscopy ; Diagnosis ; Humans ; Intestinal Obstruction ; Intestinal Volvulus* ; Precipitating Factors ; Pregnancy ; Pulmonary Disease, Chronic Obstructive ; Rare Diseases

PURPOSE: Stoma formation has usually been used for bowel decompression or fecal diversion. For these, a cecostomy is rarely performed because of disadvantages such as incomplete fecal diversion or fatal complications. The aim of this study was to evaluate the usefulness of an open cecostomy in treating patients with colonic obstruction. METHODS: Between May 2005 and August 2008, 20 patients underwent an open cecostomy because of colonic obstruction. All information on the patients was reviewed retrospectively for underlying disease, obstruction site, diameter of the cecum and transverse colon, and complications. RESULTS: Of the 20 patients, 14 had colorectal cancer, 3 had stomach cancer, 1 had cervical cancer, 1 had a carcinoid tumor, and 1 had an osteosarcoma. The cause of the obstruction was the primary tumor in 7 patients, peritoneal carcinomatosis in 7 patients, local recurrence in 5, and tissue edema after cyberknife treatment in 1 patient. All patients, except for 1 patient with a hopeless discharge due to rapid disease progression, were discharged on the tenth day postoperatively. No fatal complication developed. In 2 patients, the cecostomy closed spontaneously at 5.5 mo postoperatively after the distal obstruction had been resolved. CONCLUSION: An open cecostomy may be a useful and simple method for the decompression of a colonic obstruction, even though the diversion may not be complete.
Carcinoid Tumor ; Carcinoma ; Cecostomy ; Cecum ; Colon ; Colon, Transverse ; Colorectal Neoplasms ; Decompression ; Disease Progression ; Edema ; Humans ; Osteosarcoma ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Uterine Cervical Neoplasms

Although the creation of a colostomy is often regarded as a minor surgical procedure, complications and underlying diseases associated with colostomy creation alter the quality of life and the life-style of the patient significantly. One hundred forty-five patients underwent a colostomy at the Department of Surgery, Kangnam Sacred Heart Hospital, between 1987 and 1996. There were 83 males and 62 females, with a mean age of 52 years (range: 1 year to 89 years). Sigmoid-end colostomies were performed most commonly (60.7%). The colostomies were performed predominantly for colorectal cancer (110 cases). Complications arising from the colostomy formation occurred in 45 patients (31%), with wound infection being the most common problem observed (16 cases). Colostomy revision was required in 4 cases. Patients with cecostomies had a relatively higher incidence of stomal complications (75%) when compared to those with other types of colostomies. Postoperative complications were more common after emergency operations than after elective operations. The complication rate for patients with obstructive colorectal cancer was higher than that of patients with non-obstructive colorectal cancer. Complications occurred in 3 patients of the 29 patients underwent colostomy closure(10.3%). The incidence of surgical complications was not related to the time interval between colostomy formation and closure. The mortality rate for colostomy formation was 2.7%, and the most common cause of death was sepsis. These results suggest that careful attention to technical details and intraoperative care in the case of emergency colostomy formation for obstructive colorectal cancer are necessary to reduce the risk of postoperative complications.
Cause of Death ; Cecostomy ; Colorectal Neoplasms ; Colostomy* ; Emergencies ; Female ; Heart ; Humans ; Incidence ; Intraoperative Care ; Male ; Mortality ; Postoperative Complications ; Quality of Life ; Sepsis ; Surgical Procedures, Minor ; Wound Infection

Since its introduction as an alternative intestinal microbiota alteration approach, fecal microbiota transplantation (FMT) has been increasingly used as a treatment of choice for patients with ulcerative colitis (UC), but no reports exist regarding FMT via percutaneous endoscopic cecostomy (PEC). This report describes the case of a 24-year-old man with a 7-year history of recurrent, steroid-dependent UC. He received FMT via PEC once per day for 1 month in the hospital. After the remission of gastrointestinal symptoms, he was discharged from the hospital and continued FMT via PEC twice per week for 3 months at home. The frequency of stools decreased, and the characteristics of stools improved soon thereafter. Enteral nutrition was regained after 1 week, and an oral diet was begun 1 month later. Two months after the FMT end point, the patient resumed a normal diet, with formed soft stools once per day. The follow-up colonoscopy showed normal mucus membranes; then, the PEC set was removed. On the subsequent 12 months follow-up, the patient resumed orthobiosis without any gastrointestinal discomfort and returned to work. This case emphasizes that FMT via PEC can not only induce remission but also shorten the duration of hospitalization and reduce the medical costs; therefore, this approach should be considered an alternative option for patients with UC.
Cecostomy* ; Colitis, Ulcerative* ; Colonoscopy ; Diet ; Enteral Nutrition ; Fecal Microbiota Transplantation* ; Follow-Up Studies ; Gastrointestinal Microbiome ; Hospitalization ; Humans ; Membranes ; Mucus ; Ulcer* ; Young Adult