Malignant Colonic Obstruction Due to Extrinsic Tumor
Palliative Treatment with a Self-Expanding Nitinol Stent
Shiro Miyayama1,
Osamu Matsui2,
Koichi Kifune1,
Masashi Yamashiro1,
Toru Yamamoto1,
Kiyohide Kitagawa3,
Yoshio Kasahara4,
Yasuyuki Asada4,
Yoshiro Iida4 and
Shoji Miura4
1
Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, 7-1,
Funabashi, Wadanaka-cho, Fukui 918-8503, Japan.
2
Department of Radiology, Kanazawa University Hospital, 13-1, Takara-machi,
Kanazawa 920-8641, Japan.
3
Department of Radiology, Koseiren Takaoka Hospital, 5-10, Eiraku-cho, Takaoka
933-8555, Japan.
4
Department of Surgery, Fukuiken Saiseikai Hospital, 7-1, Funabashi,
Wadanaka-cho, Fukui 918-8503, Japan.
View larger version (53K):
[in a new window]
|
Fig. 1. —Photograph shows stent (Ultraflex; Microvasive/Boston
Scientific, Natick, MA) wrapped with 0.1-mm-thick vinyl membrane (Achilles,
Tokyo, Japan) outside delivery system. Arrowheads indicate sutures that attach
membrane. Olive tip of delivery system has been removed. Scale is in
centimeters.
|
|
View larger version (127K):
[in a new window]
|
Fig. 2A. —61-year-old man with recurrent rectal carcinoma treated
previously with Miles' operation. CT scan shows huge peritoneal mass
surrounding descending colon (arrow). Note right hydronephrosis.
|
|
View larger version (143K):
[in a new window]
|
Fig. 2B. —61-year-old man with recurrent rectal carcinoma treated
previously with Miles' operation. Spot radiograph obtained after injection of
water-soluble contrast medium through catheter inserted into proximal side of
stricture reveals 18-cm-long stricture from splenic flexure to descending
colon.
|
|
View larger version (144K):
[in a new window]
|
Fig. 2C. —61-year-old man with recurrent rectal carcinoma treated
previously with Miles' operation. Spot radiograph, obtained after placing two
uncovered stents (one 18 mm in diameter and 15 cm long, and one 18 mm in
diameter and 10 cm long) tandem, reveals good patency of stents.
|
|
View larger version (113K):
[in a new window]
|
Fig. 3. —Photograph shows 15-cm-long stent (Ultraflex;
Microvasive/Boston Scientific, Natick, MA) pushing up distal end of stent with
split sheath. Olive tip of delivery system has been removed. Scale is in
centimeters. Arrows indicate trailing end of unexpanded stent, and arrowheads
indicate metal marker and trailing end of expanded stent.
|
|
View larger version (124K):
[in a new window]
|
Fig. 4A. —76-year-old man with rectal metastasis from unresectable
gastric carcinoma. Spot radiograph obtained during barium enema in lateral
position shows 12-cm-long tight and irregular stricture in lower rectum.
Stricture extends about 5 cm above anal verge.
|
|
View larger version (119K):
[in a new window]
|
Fig. 4B. —76-year-old man with rectal metastasis from unresectable
gastric carcinoma. Spot radiograph obtained after placing uncovered stent (18
mm in diameter and 15 cm long) shows good patency of stent.
|
|
View larger version (159K):
[in a new window]
|
Fig. 5A. —38-year-old-woman with rectosigmoid metastasis from recurrent
gastric carcinoma. Colonoscopic image obtained before stent placement shows
submucosal tumor in rectum.
|
|
View larger version (135K):
[in a new window]
|
Fig. 5B. —38-year-old-woman with rectosigmoid metastasis from recurrent
gastric carcinoma. Colonoscopic image obtained 3 days after stent placement
shows wide opening of stricture and embedding of wire mesh.
|
|
View larger version (127K):
[in a new window]
|
Fig. 6A. —65-year-old man with rectal metastasis from recurrent gastric
carcinoma. Colonoscopic image obtained 23 days after stent placement shows
wide opening of stricture.
|
|
View larger version (100K):
[in a new window]
|
Fig. 6B. —65-year-old man with rectal metastasis from recurrent gastric
carcinoma. Colonoscopic image shows ulcer formation (arrow) in
stented segment.
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2000 by the American Roentgen Ray Society.
