Publication: Colonic stenting for malignant colonic obstruction with pneumatosis intestinalis: A case report
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Issued Date
2016
Resource Type
File Type
application/pdf
ISSN
22102612
Other identifier(s)
2-s2.0-84978512274
Rights Holder(s)
มหาวิทยาลัยศรีนครินทรวิโรฒ
Bibliographic Citation
International Journal of Surgery Case Reports. Vol 26, (2016), p.38-41
Suggested Citation
Phothong N., Swangsri J., Akaraviputh T., Chinswangwatanakul V., Trakarnsanga A. Colonic stenting for malignant colonic obstruction with pneumatosis intestinalis: A case report. International Journal of Surgery Case Reports. Vol 26, (2016), p.38-41. doi:10.1016/j.ijscr.2016.07.012 Retrieved from: https://hdl.handle.net/20.500.14740/5953
Abstract
Introduction Pneumatosis intestinalis is one of serious conditions following mechanical bowel obstruction. Emergency surgery is generally required to be a definite treatment in these patients of pneumatosis intestinalis, because of its risk of bowel ischemia and perforation. Since the operation in unprepared colon usually resulted in unfavorable outcome, the use of colonic stent is considered one of potential options as a bridge to definitive surgery. Presently, there is no widely published report of using colonic stent in these patients, particularly for stepping to curative surgery. Therefore, we herein report a case of obstructing sigmoid cancer with pneumatosis intestinalis who underwent successfully emergency metallic stent placement to convert from emergency to elective surgery. Presentation of case A 50-year-old woman presented with 3-day history of abdominal pain and obstipation. Abdominal computed tomography demonstrated a short segment of circumferential luminal narrowing at sigmoid colon, the presence of pneumatosis intestinalis at cecum, including ascending colon, and no extraluminal air. We performed colonoscopy and placed the metallic stent. The patient was then improved. After 1 week, the patient underwent elective hand-assisted laparoscopic sigmoidectomy and was discharged 5 days later. Pathological report showed stage IIa sigmoid cancer. The patient had no local recurrence or distant metastasis in 1 year follow up. Conclusion In obstructing colonic patient with pneumatosis intestinalis, nonsurgical treatment by colonic stenting can be used in selected patient as a bridge to definitive surgery. This will result in decreased morbidity and mortality and lower rate of stoma formation. © 2016 The Author(s)
Subject(s)
Abdominal pain
Abdominal radiography
Adult
Article
Ascending colon
Cancer staging
Cancer surgery
Case report
Cecum
Colon cancer
Colon obstruction
Colon stent
Colonoscopy
Computer assisted tomography
Constipation
Device therapy
Elective surgery
Emergency surgery
Guide wire
Hand assisted laparoscopy
Hospital discharge
Human
Male
Middle aged
Pneumatosis intestinalis
Priority journal
Self expandable metallic stent
Sigmoid
Sigmoid cancer
Sigmoidectomy
Abdominal radiography
Adult
Article
Ascending colon
Cancer staging
Cancer surgery
Case report
Cecum
Colon cancer
Colon obstruction
Colon stent
Colonoscopy
Computer assisted tomography
Constipation
Device therapy
Elective surgery
Emergency surgery
Guide wire
Hand assisted laparoscopy
Hospital discharge
Human
Male
Middle aged
Pneumatosis intestinalis
Priority journal
Self expandable metallic stent
Sigmoid
Sigmoid cancer
Sigmoidectomy