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Expandable metal stent application in obstructing carcinoma of the proximal colon: Report of a case

Campbell Kenneth L. M.D.; Hussey, Jeffrey K. M.D.; Eremin, Oleg M.D.
Diseases of the Colon & Rectum: November 1997
doi: 10.1007/BF02050829
Case Reports: PDF Only

PURPOSE: PURPOSE:The increased mortality of emergencyvs.elective colonic surgery applies equally to the right and left colon. Recent interest has surrounded the application of expandable metal stenting in acute obstruction but has been confined to the left colon. We describe successful application of stenting in the right colon, allowing postponement of a particularly high-risk laparotomy.

METHODS: METHODS:A patient with acute bilateral iliofemoral thromboses simultaneously developed complete obstruction of the proximal transverse colon. After heparinization and under fluoroscopic control, a 10-cm-long, self-expanding Wallstent®(Schneider, Bulach, Switzerland), 22 mm in diameter, was manipulated across the obstruction.

RESULTS: RESULTS:Immediate decompression with symptomatic relief ensued. The stent prevented obstruction during a 10-week period of anticoagulation, and repeat duplex scanning showed resolution of iliac thrombus. An elective right hemicolectomy was then performed. Postoperative course was uncomplicated, and histopathology confirmed a Dukes B carcinoma

CONCLUSIONS: CONCLUSIONS:This case, in which a potentially hazardous laparotomy was delayed until the operative risk improved, defines a new role for stenting in colonic obstruction and demonstrates an extension of its applicability to the right colon. Literature review found no other report of stent application in the right colon.

© The ASCRS 1997