Percutaneous colostomy for treatment of mechanical bowel obstruction: factors affecting feasibility.
OBJECTIVE
To assess the feasibility of large-bore tube colostomy in the presence of bowel obstruction in a pig model.


METHODS
Porcine spiral colon was isolated, obstructed, pressurized to 18 mm Hg, punctured with 24-F radial dilators or balloon-sheath combinations in randomized sequences, and assessed for leakage. In another experimental set, T tacks were used. The effects of various drainage configurations and systems (open vs closed) on drainage and leakage were assessed during continued gut perfusion.


RESULTS
Pressurized colon leaked 0-19.8 mL during radial dilation, 0-210 mL during balloon-sheath dilation, and 7.4-29.8 mL/min at T-tack sites. Leakage increased with minor motion. Leak-free drainage during perfusion could be obtained only with open systems or with closed systems that were inserted at least 10 cm proximal to the obstruction.


CONCLUSIONS
Percutaneous colostomy should only be attempted in very select cases with extreme attention to detail.
Carson
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Department of Radiology 3890 JPP, University of Iowa College of Medicine, Iowa City 52242, USA.
Lang
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D000818:Animals; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D003108:Colonic Diseases / Q000628:therapy*; D003125:Colostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004106:Dilatation / Q000009:adverse effects / Q000295:instrumentation; D004195:Disease Models, Animal; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D007415:Intestinal Obstruction / Q000628:therapy*; D008297:Male; D009068:Movement; D011312:Pressure; D011677:Punctures / Q000009:adverse effects; D011897:Random Allocation; D012212:Rheology; D012307:Risk Factors; D013552:Swine