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Palliative Medicine
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Percutaneous endoscopic duodenostomy: the relief of obstruction in advanced gastric carcinoma

S M Dresner

J Wayman

T Lovel

Palliative Medicine, St Benedicts Hospice, Sunderland,

N Hayes

S M Griffin

Nausea and vomiting in patients with advanced gastric malignancy and mechanical obstruction are distressing and difficult to manage. We describe a patient with linitis plastica and gastric stasis who was treated with a percutaneous endoscopic duodenostomy as the stomach could not be used for percutaneous endoscopic gastrostomy (PEG) formation. A ConfloTM PEG tube was inserted into the second part of the duodenum using the Ponsky–Gauderer technique without complication. The patient experienced excellent symptomatic relief and tolerated enteral nutrition extremely well, regaining some weight. This manoeuvre can produce effective symptom palliation allowing the patient to be managed at home during the terminal phase of their illness.

Key Words: duodenostomy • endoscopy • digestive system • palliative care • stomach neoplasms

Palliative Medicine, Vol. 13, No. 2, 165-167 (1999)
DOI: 10.1191/026921699670950414
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