Percutaneous endoscopic colostomy in a patient with chronic intestinal pseudo-obstruction and massive dilation of the colon.

A 53−year−old woman with a 17−year his− tory of multiple sclerosis, presented with abdominal pain and bowel distension. The computed tomography (CT) scan showed massive dilation of the colon (Fig− ure 1). The patient had a long history of chronic intestinal pseudo−obstruction, which so far had always resolved after co− lonoscopic decompression and placement of a colon tube. This time once again, after endoscopic evacuation of the trapped air, the patient s situation improved rapidly. In the course of the hospital stay it be− came clear that decompression was need− ed every third day. Therefore, we aimed for a permanent solution, and we chose an endoscopic approach.