Puncture and catheterization of the ascending colon for succus entericus reinfusion in a patient with a high-output single-lumen stoma: a case report.

BACKGROUND: High-output enterostomy is a common complication following ostomy procedures. In patients with loop ileostomies, the incidence of dehydration can reach 30%, and it represents the most frequent cause of readmission after ileostomy surgery, with rates as high as 16.9%. In severe cases, this condition can progress to renal failure (Dis Colon Rectum 55: 175-80, 2021, J Gastrointest Surg 17: 298-303, 2013, Nurs Stand 37: 71-6, 2022). High-output ileostomy (HOI) often imposes dietary restrictions on patients, increasing the risk of malnutrition. Previous studies have demonstrated that ileostomy fluid reinfusion can effectively address dehydration, electrolyte imbalances, renal dysfunction, and malnutrition (Gastroenterol Rep (Oxf) 12: goae100, 2024). However, the primary physiological benefit of reinfusion, particularly into the colon, is rehydration and electrolyte reabsorption, with nutritional improvement likely attributable to concurrent enteral support and intestinal adaptation.

CASE PRESENTATION: A 73-year-old female patient underwent ultrasound-guided puncture of the ascending colon for placement of a feeding tube, establishing a route for ileostomy fluid reinfusion. Combined with total enteral nutrition support and distal colon fluid reinfusion, this method was used to manage HOI in a patient with a small bowel single-lumen stoma.

CONCLUSIONS: This case demonstrates that ultrasound-guided catheterization of the ascending colon provides a feasible and effective approach for succus entericus reinfusion (SER) in patients with high-output single-lumen ileostomies. The intervention improved hydration, renal function, and nutritional status, facilitating safe stoma reversal. This technique offers a promising alternative for managing high-output stomas when conventional reinfusion pathways are not available.