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Figure 4 | BMC Gastroenterology

Figure 4

From: Colorectal tumors with complete obstruction – Endoscopic recovery of passage replacing emergency surgery? A report of two cases

Figure 4

Schematic presentation of first-step endoscopic tumor debulking. A tumorous obstruction of the distal sigmoid colon that cannot be passed with the colonoscope. Polypoid parts of the tumor are removed with the snare (B), and after replacing the colonoscope by a baby endoscope, first a soft wire and then, guided by the wire, the baby gastroscope is pushed through the stenosis (C), the scope is withdrawn, leaving the wire in place, an ERCP catheter is pushed over the wire to stabilize it, and finally a conventional gastroscope that has a working channel wide enough to use a APC probe is pushed beyond the stenosis via the ERCP catheter and the wire. Thereby, APC ablation of the tumor may be performed from the proximal part creating a channel through the tumor (D).

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