DOI: 10.12890/2025_005703

Endoscopic ultrasound-guided drainage of extraluminal colorectal mucocele using a lumen-apposing metal stent: a novel approach

Authors

  • Ryan Njeim Department of Internal Medicine, Staten Island University Hospital - Northwell Health, Staten Island, USA
  • Elie Moussa Department of Internal Medicine, Staten Island University Hospital - Northwell Health, Staten Island, USA
  • Toni Habib Department of Internal Medicine, Staten Island University Hospital - Northwell Health, Staten Island, USA
  • Omar Abureesh Department of Internal Medicine, Staten Island University Hospital - Northwell Health, Staten Island, USA
  • Saif Yasin Department of Internal Medicine, Staten Island University Hospital - Northwell Health, Staten Island, USA
  • Daniel Kalta Department of Internal Medicine, Staten Island University Hospital - Northwell Health, Staten Island, USA
  • Youssef El Douaihy Department of Gastroenterology, Staten Island University Hospital - Northwell Health, Staten Island, USA

rayn.njeim@hotmail.com

Keywords

Colorectal mucocele, endoscopic ultrasound, stent

Abstract

Colorectal mucoceles are rare mucinous cysts arising in the gastrointestinal tract and presenting diagnostic and therapeutic challenges. We report the first successful treatment of an extraluminal colorectal mucocele using a lumen-apposing metal stent (LAMS). A 65-year-old male with a known medical history of diverticulitis treated with a partial colectomy presented with constipation and low back pain. Computed tomography scan (CT) revealed a 5.4 cm cystic structure adjacent to the rectal anastomosis. Endoscopic ultrasound (EUS) found a subepithelial lesion with an “onion peel” appearance, and aspiration cytology confirmed a colo-colonic mucocele.
Management consisted of EUS-guided placement of an 8 × 8 mm LAMS, allowing for drainage, irrigation, and suctioning of the cavity. Complete resolution was achieved without recurrence over a 2-year follow-up period. This case demonstrates the potential of advanced endoscopic techniques, particularly LAMS, in managing extraluminal colorectal mucoceles. While further research is needed to compare the efficacy of LAMS with other treatment modalities, this procedure offers a minimally invasive alternative to surgery for certain patients.

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References

  1. Ishii D, Aoki T, Inaba S, Yabuki H. Rectal mucocele in the anterior wall of the rectum. BMJ Case Rep 2018;2018:bcr2018225097. doi: 10.1136/bcr-2018-225097
  2. Longchamp G, Colucci N, Ris F, Buchs NC. Rectal stump mucocele after a Hartmann’s procedure causing mechanical ileus. BMJ Case Rep 2021;14:e237543. doi: 10.1136/bcr-2020-237543
  3. Ali A, Krishnan A, Rehman S, Rao V, Pearson HJ. Giant colonic mucocele following palliative surgery for metastatic adenocarcinoma. J Surg Case Rep 2011;2011:1-4. doi: 10.1093/jscr/2011.3.9
  4. Schneider R, Kraljevic M, von Flüe M, Füglistaler I. Giant Symptomatic Rectal Mucocele following Subtotal Colectomy. Case Rep Gastroenterol 2018;12:143-146. doi: 10.1159/000488523
  5. Draeger TB, Aslam U, Mokraoui N, Seitelman E, Datta R, Amajoyi RC. Intersphincteric proctectomy for rectal mucocele in a Crohn’s patient with anal stenosis. A case report and review of literature. Int J Surg Case Rep 2018;44:148-151. doi: 10.1016/j.ijscr.2017.12.039
  6. Subhas G, Balaraman S, Mittal VK, Pearlman R. Extraluminal rectal mucocele resulting from bowel sequestration at the anastomotic site after sigmoidectomy. Am Surg 2010;76:107-108.
  7. DaCunha T, Dharan M. Endosonographic Diagnosis of Rectal Mucocele: The “Onion Skin” Sign. ACG Case Rep J 2022;9:e00813. doi: 10.14309/crj.0000000000000813
  8. Teoh AY, Lee JF, Chong CC, Tang RS. Endoscopic ultrasonography-guided drainage of a rectal mucocele after total colectomy for Crohn’s disease. Endoscopy 2013;45:E252-253. doi: 10.1055/s-0033-1344415
  9. Ai XB, Feng JC, Gong FY, Wang A, Ren DH, Sui K. Endoscopic therapy of colonic liver flexure mucocele. Case Rep Gastroenterol 2011;5:433-437. doi:10.1159/000330484
  10. Sharma P, McCarty TR, Chhoda A, Costantino A, Loeser C, Muniraj T, et al. Alternative uses of lumen apposing metal stents. World J Gastroenterol 2020;26:2715-2728. doi:10.3748/wjg.v26.i21.2715

Published

2025-08-19

How to Cite

1.
Njeim R, Moussa E, Habib T, Abureesh O, Yasin S, Kalta D, et al. Endoscopic ultrasound-guided drainage of extraluminal colorectal mucocele using a lumen-apposing metal stent: a novel approach. EJCRIM [Internet]. 2025 Aug. 19 [cited 2026 Nov. 3];12(9). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5703

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