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Palliative colonic stent placement
PALLIATIVE COLONIC STENT PLACEMENT
A
B
C A 68-year-old woman with widely metastatic colorectal carcinoma presented with nausea, vomiting, and obstipation. She had previously undergone a right hemicolectomy with ileocolonic anastomosis for removal of the primary tumor. She appeared ill and cachectic. A large abdominal mass was palpable. CT revealed a large tumor mass with obstruction of the small intestine (A, arrow). Supportive measures were initiated including intravenous administration of fluids and nasogastric suction. At colonoscopy, there was a large, obstructing intraluminal mass at the ileocolonic anastomosis (B). Under fluoroscopy, a long, looping stricture was identified. Several overlapping,
VOLUME 56, NO. 5, 2002
D expandable metal stents were placed endoscopically across the malignant obstruction (C, D). The patient tolerated the procedure well and was able to resume oral feedings 1 day later. She was discharged to hospice care 2 days after the procedure. The patient died of advanced colon cancer 1 month after procedure, without any known recurrence of her obstruction. William Sanchez, MD Todd H. Baron, MD Mayo Clinic Rochester, Minnesota doi:10.1067/mge.2002.127149
GASTROINTESTINAL ENDOSCOPY
735
A
B
C A 68-year-old woman with widely metastatic colorectal carcinoma presented with nausea, vomiting, and obstipation. She had previously undergone a right hemicolectomy with ileocolonic anastomosis for removal of the primary tumor. She appeared ill and cachectic. A large abdominal mass was palpable. CT revealed a large tumor mass with obstruction of the small intestine (A, arrow). Supportive measures were initiated including intravenous administration of fluids and nasogastric suction. At colonoscopy, there was a large, obstructing intraluminal mass at the ileocolonic anastomosis (B). Under fluoroscopy, a long, looping stricture was identified. Several overlapping,
VOLUME 56, NO. 5, 2002
D expandable metal stents were placed endoscopically across the malignant obstruction (C, D). The patient tolerated the procedure well and was able to resume oral feedings 1 day later. She was discharged to hospice care 2 days after the procedure. The patient died of advanced colon cancer 1 month after procedure, without any known recurrence of her obstruction. William Sanchez, MD Todd H. Baron, MD Mayo Clinic Rochester, Minnesota doi:10.1067/mge.2002.127149
GASTROINTESTINAL ENDOSCOPY
735