VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2026
Salvage reconstruction of an endoscopic ultrasound-guided gastroenterostomy using a tubular enteral stent after inadvertent transcolonic lumen-apposing metal stent deployment.
СтатьяНазвание и аннотация: Перевод в очереди
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Martins Miguel, Mota Joana, Vilas-Boas Filipe, Moutinho-Ribeiro Pedro, Lopes Susana, Bouça-Machado Tiago, Macedo Guilherme
Аннотация
BACKGROUND AND AIMS: EUS-guided gastroenterostomy (EUS-GE) is effective for palliating malignant gastric outlet obstruction (GOO). Inadvertent gastrocolostomy, although rare, can be a serious adverse event. We present an endoscopic rescue strategy in a case of gastrocolonic and colojejunal fistula after EUS-GE.
METHODS: A 59-year-old woman with duodenal adenocarcinoma underwent EUS-GE with a 20- × 10-mm lumen-apposing metal stent (LAMS) because of GOO. One week later, the patient presented with postprandial diarrhea, nausea, and halitosis. Imaging and endoscopy revealed a gastrocolonic fistula and a mature colojejunal fistula.
RESULTS: Under endoscopic and fluoroscopic guidance, a partially covered self-expandable metal stent was deployed transcolonically through the LAMS into the jejunum. The procedure was uneventful. The patient resumed oral intake within 24 hours, and follow-up confirmed correct stent positioning and clinical improvement.
CONCLUSIONS: Transcolonic stent placement through the LAMS appears to be a feasible rescue solution for managing inadvertent gastrocolostomy after EUS-GE in the presence of a concurrent colojejunal fistula.
METHODS: A 59-year-old woman with duodenal adenocarcinoma underwent EUS-GE with a 20- × 10-mm lumen-apposing metal stent (LAMS) because of GOO. One week later, the patient presented with postprandial diarrhea, nausea, and halitosis. Imaging and endoscopy revealed a gastrocolonic fistula and a mature colojejunal fistula.
RESULTS: Under endoscopic and fluoroscopic guidance, a partially covered self-expandable metal stent was deployed transcolonically through the LAMS into the jejunum. The procedure was uneventful. The patient resumed oral intake within 24 hours, and follow-up confirmed correct stent positioning and clinical improvement.
CONCLUSIONS: Transcolonic stent placement through the LAMS appears to be a feasible rescue solution for managing inadvertent gastrocolostomy after EUS-GE in the presence of a concurrent colojejunal fistula.