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Symptomatic resolution of malignant bowel obstruction by endoscopic catheterisation of an enterocutaneous fistula
  1. Taha Haq1,2 and
  2. Dermot Burke2,3
  1. 1 Leeds Institute of Emergency General Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2 Leeds Institute of Medical Education, University of Leeds, Leeds, UK
  3. 3 John Goligher Colorectal Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Taha Haq; taha.haq{at}


Patients with advanced intra-abdominal malignancy frequently experience nausea and vomiting, however these symptoms can be difficult to manage. A woman in her seventies with high grade primary peritoneal adenocarcinoma developed intermittent small bowel obstruction following extensive surgery. Poor relief was provided by pharmacological approaches and nasogastric tube insertion. Further surgical management was deemed unsuitable due to the significant possibility of complications and likely impairment of the patient’s quality of life. A conservative approach was used by using a novel therapeutic intervention: an endoscope was used to visualise an enterocutaneous fistula tract proximal to the obstruction and a gastrostomy catheter was fluoroscopically inserted. This maintained fistula tract patency, permitting drainage of bowel contents and therefore resolving the patient’s symptoms. We therefore describe a novel therapeutic approach where endoscopic insertion of a gastrostomy catheter maintained patency of an enterocutaneous fistula, enabling lasting relief of bowel obstruction in a manner acceptable to the patient.

  • gastrointestinal surgery
  • general surgery
  • endoscopy

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  • Contributors TH (corresponding author) compiled the manuscript and DB reviewed and edited the manuscript and was responsible for obtaining the patient's consent.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.