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At the focal point| Volume 97, ISSUE 2, P370-371, February 2023

EUS-guided ileorectal anastomosis for relief of complete benign small-bowel obstruction (with video)

Published:September 22, 2022DOI:https://doi.org/10.1016/j.gie.2022.09.007
      A 52-year-old man underwent an ileorectal anastomosis after a subtotal colectomy because of acute complicated diverticulitis. Seven days later, a CT scan revealed a pneumoperitoneum (A), but no clear perforation was discovered during surgery. Endoscopy disclosed a complete stenosis of the anastomosis, 15 cm from the dentate line, which prevented us from advancing a guidewire (B). A linear-array echoendoscopy (performed with EUS) was performed through the rectum, and the ileal loop with liquid inside was identified. The ileal loop was punctured with a 19-gauge needle, allowing further passage of the 0.025 mm guidewire. A 15 mm × 10 mm lumen-apposing metal stent (LAMS) was then deployed (C, (Video 1, available online at www.giejournal.org)).
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