Temporary cecostomy as a life saving measure for functional obstruction secondary to neutropenic colitis

Percutaneous cecostomy is mainly used to treat chronic neurogenic constipation in children. It may also be performed for emergency decompression of large bowel obstruction or to allow antegrade stenting in right-sided colonic obstruction. However, there are no dedicated or licensed tubes available for this purpose, and owing to the increased intracolonic pressure from the underlying obstruction, there is a high risk of fecal leak and peritonitis. We describe a unique case of emergency percutaneous cecostomy for functional obstruction because of severe neutropenic colitis of the sigmoid colon. The cecum was fixed with four T-fasteners designed for gastropexy during radiological gastrostomy, and a large gastrostomy feeding tube was inserted. Drainage of fecal matter was difficult and intermittent; however, it allowed sufficient decompression of the bowel to prevent perforation until the neutropenic colitis resolved. In the absence of dedicated drainage systems for the bowel, standard gastrostomy kits can be used as an emergency measure in life-threatening large bowel obstructions if surgical options or stenting are inappropriate.