A Case of Rectal Cancer with Colonic Perforation Two Weeks Following Placement of A Colonic Stent

Abstract

A 67-year-old man was referred to our hospital for a feeling of fullness. CT scan revealed multiple liver metastases and thickening of the rectal wall. CT scan also revealed a large quantity of pooling stool, so we diagnosed ileus due to colorectal cancer. Therefore a colonic stent (WallFlex metallic stent 22mm×90mm) was inserted on the day of the operation. Fourteen days later, the patient developed acute abdominal pain. CT scan revealed free air suggesting gastrointestinal perforation. Therefore emergency surgery was performed. At the surgery it was noticed that the intestinal wall at the proximal end of the stent was perforated, so we employed a Hartmann operation by preforming the associated resection of the colonic stent and the intestine. A colonic stent is effective for ileus due to colorectal cancer, but colonic perforation due to the colonic stent can lead to a fatal situation. We should use such a stent thinking of the risk of perforation at all times.