Alternative use of the Salem probe, thinking outside the box.

Abstract Colonic decompression is an effective therapeutic option for the management of acute colonic dilation associated with various conditions, including Ogilvie’s syndrome, colonic volvulus, and malignant or benign colonic obstruction. Fluoroscopy-guided transanal decompression tube placement has proven to be a safe and cost-effective procedure, capable of avoiding emergency surgery and serving as a bridge to definitive treatment. We present two clinical cases in which colonic decompression was performed using a Salem tube, previously perforated at its distal end and advanced over a guidewire, as an alternative when specialized devices were not available at our center. In both cases, adequate colonic decompression and favorable clinical outcomes were achieved. The use of a Salem tube over a guidewire represents an effective and accessible alternative for colonic decompression in selected situations, particularly in resource-limited settings.