Stents are tubular devices made of plastic or metal. Endoscopic stenting is the most common treatment for obstruction of the common bile duct or of the main pancreatic duct, but also employed for the treatment of bilio-pancreatic leakages, for preventing post- endoscopic retrograde cholangiopancreatography pancreatitis and to drain the gallbladder and pancreatic fluid collections. Recent progresses in techniques of stent insertion and metal stent design are represented by new, fully-covered lumen apposing metal stents. These stents are specifically designed for transmural drainage, with a saddle-shape design and bilateral flanges, to provide lumen-to-lumen anchoring, reducing the risk of migration and leakage. This review is an update of the technique of stent insertion and metal stent deployment, of the most recent data available on stent types and characteristics and the new applications for biliopancreatic stents.
Introduction Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of intramural gas cysts within the small and large intestines. We describe a case of a 70-year-old man admitted to the Emergency Surgery Department for PCI who was treated conservatively. Areas Covered We reviewed 60 cases of PCI described in the international literature over the last 5 years. From our analysis, it appears that the etiology of the gas production within the submucosa or the subserosa of the gastrointestinal tract is still unknown. The rupture of the cysts can lead to pneumoperitoneum that can simulate a surgical emergency. Expert Commentary For patients with PCI, a conservative approach is the treatment of choice, with surgery mandatory only for complicated disease.
Keywords Pneumatosis cystoides intestinalis • Conservative management • Spontaneous pneumoperitoneum
Abbreviations
CTComputed tomography scan PCI Pneumatosis cystoides intestinalis COPD Chronic obstructive pulmonary disease
Case Report and EvolutionA 70-year-old man was admitted to the Emergency Department of St. Orsola University Hospital-Bologna-due to the onset of abdominal pain associated with rectorrhagia. His past medical history included hypertension, atrial fibrillation treated with oral anticoagulants, an episode of stroke with dysphagia and dysarthria, cerebrovascular disease, nephrectomy for renal cancer, and diabetes mellitus. In the emergency department, physical examination, blood tests, and chest X-ray were performed. Physical examination was remarkable for upper abdominal direct tenderness in the * A. Lauro
OTSC placement should be attempted after perforation occurring during diagnostic or therapeutic endoscopy. A failed closure attempt does not impair subsequent surgical treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.