抄録
A 54-year-old female with abdominal pain was referred to our hospital. The patient had previous history of gastric cancer with colorectal metastases. A CT scan showed dilatation of small intestine along with irregular thickening of the colon suggesting an obstruction of the colon. With informed consent obtained, we attempted stenting for palliation of colorectal obstruction, because the patient denied surgical treatment. An initial trial of stenting in the transverse colon with the help of a guidewire was failed due to an acute angle at the splenic flexure. The stent was therefore placed in the stenotic sigmoid colon. The patient continued to suffer from bowel disturbance. A further attempt at stenting in the transverse colon was made. A double-balloon enteroscope (DBE) was inserted in the transverse colon. Leaving an overtube in place with a guidewire through the stenosis, the DBE was withdrawn. Two stents were then successfully placed in the transverse colon through the overtube with the help of the guidewire. The patient could tolerate a diet two days after stenting.
There is no exclusive device for colorectal stenting in Japan. Particularly in cases of proximal colonic stenosis as in this case, the long tortuous colon makes stenting difficult. The method using DBE seems to be a useful technique of colonic stenting, because DBE permits easy insertion into the deeper intestine.
