Abstract
Percutaneous endoscopic colostomy (PEC) was first described in 1986, by Jeffrey Ponski 1, who had invented percutaneous endoscopic gastrostomy a few years before that 2. Performed by 2 operators, PEC consists of placing a tube in the colon during colonoscopy in order to provide antegrade colonic enemas (ACE) in severe constipation or fecal incontinence 3 4. The PEC tube can also be used as a tool allowing easier and immediate colonic exsufflation in Ogilvie’s syndrome or chronic intestinal obstruction 5 6. In the majority of PEC indications, the colostomy tube is placed in the cecum for 2 main reasons: 1) to allow pancolonic rather than distal ACE in order to (theoretically) provide more effective bowel function; and 2) cecal transillumination as a prerequisite to improve procedure ease and safety because it helps determine the most direct route to the colon. So far, whether performing PEC is safe and effective in other situations, such as sigmoid volvulus, remains largely unknown.
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