Abstract
A 57-year-old man having undergone total gastrectomy for gastric cancer was admitted to the hospital because of difficulty in swallowing. Endoscopic examination revealed a severe stenosis in the jejunum 5cm distal to the esophago-jejunal anastomosis. With abdominal CT and rectal examination, we made a diagnosis of malignant stenosis due to peritoneal dissemina-tion. We decided to place a covered self-expandable metallic stent. However, the delivery system could not pass through the bend because the jejunum was bent. Then a silk gut tied up to the delivery system was grasped with forceps endoscopically, and the delivery system was led successfully. After placement of the stent, the patient could leave the hospital and take food for 4 months. Against re-stenosis, a stent-in-stent technique was also made. The stent placement for jejunal stenosis is relatively difficult. This technique could apply to these cases, and would improve a quality of life for these patients.
