Abstract
Endoscopic stenting for malignant large bowel obstruction is common nowadays. However, recurrent obstruction secondary to stent occlusion due to tumour ingrowth or overgrowth might occur. We reported a case of a 70-year-old man with large bowel obstruction initially treated with colonic stenting. It was complicated with recurrent intestinal obstruction, with colonoscopy showing stent blockage by tumour ingrowth over distal part of the stent. Successful endoscopic implantation of additional colonic stent over the old stent was achieved and intestinal obstruction was resolved afterwards.
Highlights
We reported a case of a 70-year-old man with large bowel obstruction initially treated with colonic stenting
Surgery was the only option in the past for malignant large bowel obstruction (LBO), which usually presents as surgical emergency
While clinical resolution of intestinal obstruction usually happens within several days of successful placement of self-expandable metallic stent (SEMS), delayed stent occlusion due to tumour ingrowth or overgrowth had been reported in literatures [1], especially with the use of uncovered stents, leading to recurrent obstruction
Summary
Surgery was the only option in the past for malignant large bowel obstruction (LBO), which usually presents as surgical emergency. Endoscopic placement of self-expandable metallic stent (SEMS) is increasingly practised nowadays with low mortality rates [1]. While clinical resolution of intestinal obstruction usually happens within several days of successful placement of SEMS, delayed stent occlusion due to tumour ingrowth or overgrowth had been reported in literatures [1], especially with the use of uncovered stents, leading to recurrent obstruction. We report a case of malignant LBO using covered stent, resulting in recurrent intestinal obstruction due to ingrowth in the distal part, which was successfully managed by endoscopic implantation of additional colonic stent
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