Treatment of colonic obstruction with expandable metal stents: radiologic features

AJR. American Journal of Roentgenology
C CanonR E Koehler

Abstract

The purpose of this prospective study was to evaluate the efficacy of expandable metal stents for colonic decompression in patients presenting with acute malignant obstruction and to describe the associated radiographic findings. Using both fluoroscopic and endoscopic guidance, we placed expandable metal stents within the colons of 13 patients presenting with acute malignant obstruction. Stents were placed in four patients to permit a standard bowel cleansing before surgical resection with primary anastomosis. In the other nine patients, stents were placed for palliation of nonresectable tumors, obviating colostomy. Outcomes and complications were analyzed. The radiologic aspects of procedural planning, stent placement, assessment after placement, and detection of complications were evaluated. Of the four surgical candidates who were successfully resected with primary anastomosis, two received incomplete bowel cleansing because of stent migration with recurrent obstruction. Eight of the nine patients who had stents placed for palliation of nonresectable tumors had relief of acute obstruction. Complications in this group included two perforations, one that required immediate colostomy and one that was self-limited and conservati...Continue Reading

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