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Hole-making technique for the treatment for acute pancreatitis due to placement of a fully covered duodenal metallic stent
- Source :
- Endoscopy. 47
- Publication Year :
- 2015
-
Abstract
- Duodenal stent placement has been developed as an alternative to surgical gastrojejunostomy [1]. Compared with uncovered metallic stents, duodenal fully covered metallic stents offer advantages, such as the prevention of tumor ingrowth, and thus lower occlusion rates [2]. However, duodenal fully covered metallic stents also have several disadvantages, such as stent migration [3]. Acute pancreatitis is another adverse event associated with duodenal stent placement, occurring at a frequency of approximately 4% [4,5]. In previous reports, acute pancreatitis has been treated conservatively. If a fully covered metallic stent is placed in the duodenum, the frequency of acute pancreatitis may be increased, and the treatment of acute pancreatitis may prove difficult. We report herein a novel treatment for acute pancreatitis due to duodenal placement of a fully covered metallic stent. A 78-year-old man was admitted to our hospital because of vomiting and obstructive jaundice. He was undergoing chemotherapy for bladder cancer. Computed tomography showed a duodenal stenosis, attributed to lymph node metastasis. No other site of stenosis was detected, so we attempted duodenal stent placement. First, we advanced the endoscope into the duodenum, and contrast medium was injected. The second part of the duodenum was obstructed (●" Fig.1). Then, we placed a fully covered metallic stent (ComVi, 20mm×12 cm; TaeWoong Medical, Seoul, South Korea) in the duodenum (●" Fig.2). Although the vomiting resolved completely, acute pancreatitis developed. Computed tomography showed dilatation of the Fig.1 A duodenal stenosis is apparent (arrows) in a 78-year-oldmanadmittedwith vomitingand obstructive jaundice.
- Subjects :
- Male
medicine.medical_specialty
Endoscope
medicine.medical_treatment
Duodenal stenosis
medicine
Humans
Aged
business.industry
Gastroenterology
Stent
equipment and supplies
medicine.disease
Surgery
Stenosis
medicine.anatomical_structure
Pancreatitis
Acute Disease
Duodenum
Vomiting
Acute pancreatitis
Stents
Radiology
Duodenal Obstruction
medicine.symptom
business
Subjects
Details
- ISSN :
- 14388812
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- Endoscopy
- Accession number :
- edsair.doi.dedup.....55a4dc6b8866317c3e238dbe0013d186