A Case of Sigmoidorectal Intussusception after Self-Expandable Colonic Stent Placement |
Chang Kyun Lee, Hyo Jong Kim, Jae Young Jang, Seok Ho Dong, Byung-Ho Kim, Young Woon Chang, Rin Chang, Hyoung Jung Kim, Kil Yeon Lee |
Departments of Internal Medicine, Diagnostic Radiology and Surgery†, Kyung Hee University College of Medicine, Seoul, Korea
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자가팽창형 대장 스텐트 유치 후 발생한 구불결장-직장 장중첩증 1예 |
이창균, 김효종, 장재영, 동석호, 김병호, 장영운, 장린, 김형중, 이길연 |
경희대학교 의과대학 내과학교실, 영상의학교실 |
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Abstract |
Self-expandable metallic stents are widely used to relieve acute colorectal obstruction that's secondary to malignancy. They are utilized for both palliation and preoperative decompression prior to colorectal surgery. Although stents have been documented as a relatively safe therapeutic modality, procedure-related complications such as perforation, bleeding, stent reobstruction and migration can occur during or after colonic stent placement. Therefore, clinicians must be aware of the various complications associated with colonic stent placement. We present here a very rare case of sigmoidorectal intussusception that developed after fluoroscopic placement of a self-expandable metallic stent for preoperative decompression of sigmoid colon cancer. We misdiagnosed the intussusception as a distal stent migration on the plain radiography. On the sigmoidoscopic examination to evaluate the unrelieved colonic obstruction, we diagnosed a sigmoidorectal intussusception of the stent-implanted malignant tumor. The patient was successfully treated by laparoscopic partial reduction, followed by a curative anterior resection. This case demonstrates that careful examination must be done in cases of unrelieved colonic obstruction with suspicious stent migration, and intussusception must be considered as a rare complication of self-expandable metallic stent placement in the colon. (Intest Res 2008;6:70-75) |
Key Words:
Colonic Neoplasms, Intussusception, Stents |
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