• Am J Emerg Med · Apr 2014

    Case Reports

    Cecal pneumatosis intestinalis in obstructing sigmoid cancer in ED: Emergency metallic stenting.

    • Hsu-Heng Yen, Fu-Yuan Siao, and Kai-Yu Fong.
    • Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan, ROC. Electronic address: 153299@cch.org.tw.
    • Am J Emerg Med. 2014 Apr 1;32(4):395.e1-3.

    AbstractAn 85-year-old man presented with acute abdomen. Abdominal computed tomography revealed obstructing sigmoid colon cancer with pneumatosis intestinalis of the ascending colon. A surgeon was consulted for colonic obstruction with impending sepsis, who declined surgery considering the patient's advanced age. After discussion, the patient consented for emergent endoscopic metallic colonic stent placement. Complete obstruction of the lumen was observed at the sigmoid colon, followed by successful metallic colonic stent placement through the obstructed area. Normal stool passage was achieved after this, and the patient survived the 9-month follow-up period. Acute colonic obstruction from obstructive colon cancer requires emergency management, wherein the presence of pneumatosis intestinalis poses a high risk of cecal perforation. Emergency endoscopic colonic metallic stent placement provides an alternative therapy, particularly when surgery is not feasible, as described here.

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