Percutaneous endoscopic cecostomy in the treatment of recurrent colonic pseudo-obstruction - a case report of the first procedure in the Czech Republic

Abstract

We present the case of an 89-year-old polymorbid female patient with recurrent acute colonic pseudo-obstruction who was treated by performing
percutaneous endoscopic cecostomy as the first procedure of its kind in the Czech Republic. The patient presented repeatedly with ileous conditions
without evidence of an organic cause. Surgical colostomy was proposed with a possibility of subtotal colectomy as an ultimum refugium
due to an insufficient effect of maximum conservative management and a need for repeated endoscopic decompression. In this particular patient,
however, any kind of surgical intervention posed a major risk and was eventually abandoned. Finally, percutaneous endoscopic cecostomy was
proposed as an alternative to resolve the situation. The procedure was carried out without complications and with an immediate effect. The patient
has been free of the symptomatology of intestinal obstruction in the long term having the option of intermittent intestinal decompression as
needed.