Abstract
An 88-year-old woman visited our hospital with complaints of anorexia and weight loss. Computed tomography suggested colon cancer of the ascending colon with Douglas pouch metastasis and lung and liver metastases. Colonoscopy was performed to confirm the diagnosis of ascending colon cancer, but the colonoscope could not be passed through the rectosigmoid region because of the presence of a stenotic mass resulting from the Douglas pouch metastasis. A self-expandable metallic stent (SEMS) was inserted at this site through the scope. Expansion of the stenosis with the SEMS allowed the scope to pass through this stenotic region and approach the ascending colon, resulting in the diagnosis of ascending colon cancer, which had obstructed the passage of the scope. A second SEMS was subsequently inserted into the area of the tumor in the ascending colon for decompression. Herein, we report a case in which SEMS contributed to the diagnosis of a lesion located proximal to the stenosis and allowed for decompression of the colon in patients with two incurable malignant colonic obstructions, thereby avoiding surgery and improving quality of life. We also report a literature review of definitive palliation by using SEMS in patients with incurable malignant colon obstructions.
