COLONIC PSEUDOOBSTRUCTION - DECOMPRESSION WITH A TRICOMPONENT COAXIALSYSTEM UNDER FLUOROSCOPIC GUIDANCE

A tricomponent coaxial system (TAS) suitable for colonic decompression with fluoroscopic guidance is described. The TAS was successfully use d in four of four patients, two with acute pseudo-obstruction, one wit h sigmoid volvulus, and one with recurrent colonic pseudo-obstruction. All patients had acute abdominal distention with cecal diameter of at least 12 cm, and nonsurgical management was unsuccessful. Complete co lonic decompression was observed in all four patients, with no recurre nce in three of three patients after removal of the decompression cath eter. The decompression catheter was left in place in one patient for her comfort until she died of hepatic failure 4 days later. There was no associated colonic bleeding or perforation in any of the four cases . The procedure lasted approximately 20-90 minutes. The TAS promises t o be a useful and inexpensive tool with which to perform colonic decom pression in selected patients.