A successful stent insertion using endoscopic techniques for intestinal invasion by pancreatic cancer

Abstract

A 63-year-old man with peritoneal dissemination of pancreatic tail cancer after stent placement in the descending colon was admitted due to persistent vomiting. CT scan revealed gastrointestinal obstruction was caused by invasion of the pancreatic tail cancer near the Treitz ligament. Stent placement was attempted using short single-balloon enteroscopy (sSBE). Although sSBE reached near the Treitz ligament, the lumen of the stenosed area could not be visualized due to the angulation. Later, after placing a sliding tube into the duodenum using sSBE, an ultra-thin scope was inserted, allowing the identification of the stenotic lumen. After placing a guidewire in the small intestine, sSBE was reinserted, and a gastrointestinal stent was placed. In this case, the procedure was completed using a combination of sliding tube and ultra-thin scope.