Commentary

This video by Hu et al. [11] presents an important contribution to the management of acute colorectal obstruction. Although combined use of endoscopy and fluoroscopy should be considered when placing colonic stents [22], however in critically ill patients, as well as in situations where radiation exposure should be minimized, endoscopic monitoring may be the only option. Even though a pediatric endoscope may allow management of moderately tight strictures if located in the distal colon, this new method may be particularly useful for more proximal and tighter strictures. The small caliber of the cholangioscope and its 4-way directional control of the tip may allow these strictures to be navigated without fluoroscopy assistance, and the possibility of traversing the stricture may also add additional information on upstream mucosal viability. Its use, however, should be limited to selected cases, taking into consideration the price of the device.

Publication History

Article published online:
30 July 2024

• References

• 1 Hu J, Zheng J, Yang C. et al. A radiation-free novel approach for intestinal stent placement: the “scope-in-scope” technique. Endoscopy 2024; 56: E313-E314 DOI: 10.1055/a-2291-9315. (PMID: 38593996)
• 2 van Hooft JE, Veld JV, Arnold D. et al. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2020. Endoscopy 2020; 52: 389-407 DOI: 10.1055/a-1140-3017. (PMID: 32259849)