Self-expanding metallic stents in the treatment of benign colorectal anastomotic strictures: a word of caution

Abstract

A 66-year-old man underwent an anterior resection for carcinoma at the rectosigmoid junction. Three months later, a tight stricture developed proximal to the anastomosis. This was treated with a self-expanding metallic stent. Over the next few months, the stent fractured and a fistula developed between the site of anastomic stricture and the distal ileum; the stent had to be removed. This, to our knowledge, is the first report of a coloenteric fistula developing after insertion of a metallic stent to treat a benign postoperative anastomotic stricture.

Enterocolic fistula due to a rectal stent: Case report and literature review

“…A deep ulcer was found in the resected specimen suggesting that the underlying disease process might be the reason for fistula formation rather than the metallic stent. Modarai et al., reported a case in which a 66 year old man developed a tight anastomotic stricture after resection of a rectosigmoid junction carcinoma [7] . This was treated with a SEMS.…”

When a Colonic Metal Stent is Left in for Too Long: A Devastating Coloenteric Fistula from Stent Erosion and Migration

“…3 Although enterocutaneous fistulas have frequently been reported as a sequela of colonic stents, there have been few reports of a metallic stent resulting in a coloenteric fistula. 2,4 Herein, we describe the case of a 37-year-old man who had undergone colonic resection and primary hand-sewn anastomosis for complicated diverticulitis three years ago in his native country. His immediate postoperative course was complicated with anastomotic leak, which was managed with percutaneous drainage.…”

“…2 Coloenteric fistula is a known but exceedingly rare complication of endoscopic stent placement for a benign colonic stricture. 2,4 Owing to such complications and compounding by insufficient data on long-term lumen patency, stent application for benign stricture remains controversial. 1,2 In our case, the patient was unfortunately lost to follow-up and the stent remained for two years causing complete erosion and migration of the stent into the jejunum.…”