Repeated coaxial colonic stenting in the palliative management of benign colonic obstruction

Abstract

In inflammatory bowel disease, strictures of the colon, causing bowel obstruction, is not uncommon. Usually an operative procedure can deal with these strictures. We describe a case of an unfit patient with pulmonary malignancy having a Crohn's stricture of the recto-sigmoid junction in which repeated coaxial placement of self-expanding metallic stents eliminated the need to perform an operation. This is the first report of multiple coaxial colonic stenting. It shows that there is a place for stents in selected cases of inflammatory bowel disease with a limited life expectancy and that repeated colonic stenting makes colonic stenting possible also in patients requiring stents for longer time periods.

Outcome of patients after endoluminal stent placement for benign colorectal obstruction

“…There is limited data on longterm follow-up and randomised studies do not exist. Many of the studies are case reports or the study populations are small [8][9][10][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. At the time of writing this report, the biggest series of patients treated with SEMS due to benign obstruction is 23 patients [11].…”

Endoprosthetic management of refractory ileocolonic anastomotic strictures after resection for Crohnʼs disease: Report of nine-year follow-up and review of the literature

“…These results have prompted some authors to conclude that SEMS may be inappropriate for long-term management of CD obstruction and should only be used as a temporary bridge to surgery or in patients with limited life expectancy. 2,9,13,14 The present study, however, suggests a more hopeful outlook, with a mean stent duration over twice as long (24 months), a complication rate of just 20% (n ¼ 1), and an average long-term luminal patency of 34.8 months in the four patients who did not require early reintervention. There were no technical problems, migrations, or late complications.…”

The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction

“…[99][100][101][102][103][104] However, these case reports do not provide sufficient data to determine the role of SEMS in these settings.…”