title: Percutaneous endoscopic cecostomy in adults: a case series.
abstract: BACKGROUND
  Percutaneous cecostomy is used to treat recurrent colonic pseudoobstruction or obstipation in children and adults with multiple medical comorbidities. Percutaneous endoscopic cecostomy is a potentially attractive alternative to surgical or fluoroscopic cecostomy placement. A few reports describe percutaneous endoscopic cecostomy for management of these problems in children, whereas there are no large series of percutaneous endoscopic cecostomy in adult patients describing the indications, complications, and outcomes.
  
  
  OBJECTIVE
  Report our experience with percutaneous endoscopic cecostomy in adults.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Single tertiary referral center in the United States.
  
  
  METHODS
  Five patients with recurrent colonic pseudoobstruction and 2 with chronic refractory constipation.
  
  
  METHODS
  Percutaneous endoscopic cecostomy.
  
  
  RESULTS
  Eight cases of percutaneous endoscopic cecostomy were performed from May 2001 through October 2005: 6 for colonic pseudoobstruction and 2 for chronic constipation. Seven of 8 cases were successful and resulted in clinical improvement. One patient required surgical removal of the percutaneous endoscopic cecostomy tube at 4 days for fecal spillage resulting in peritonitis despite successful tube placement for chronic constipation. Removal of the cecostomy tube occurred in 3 of 6 cases of pseudoobstruction (the other 3 remain in place). In the other patient with chronic constipation, clinical improvement occurred, but the patient died of underlying illness 21 days after placement. No other serious complications occurred.
  
  
  CONCLUSIONS
  Retrospective, single-center study.
  
  
  CONCLUSIONS
  Percutaneous endoscopic cecostomy is a viable alternative to surgically or fluoroscopically placed cecostomy in a select group of patients with recurrent colonic pseudoobstruction or chronic intractable constipation.
authors.affiliation: Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Lynch
authors.forename: Robert G
authors.initials: RG
authors.lastname: Jones
authors.forename: Kristen
authors.initials: K
authors.lastname: Hilden
authors.forename: Jason C
authors.initials: JC
authors.lastname: Wills
authors.forename: John C
authors.initials: JC
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002432:Cecum / Q000601:surgery*; D002908:Chronic Disease; D003112:Colonic Pseudo-Obstruction / Q000601:surgery*; D003248:Constipation / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies