[Stent placement using a double-balloon endoscope for malignant duodenal obstruction with Roux-en-Y Anastomosis-a case report].

Research output: Contribution to journalArticle

Abstract

A 79-year-old man who had previously undergone partial resection of the remnant stomach and Roux-en-Y reconstruction was diagnosed as having peritoneal recurrence near the ligament of Treitz. In the course of chemotherapy for recurrent gastric cancer, he complained of colic pain. CT examination revealed a marked dilation of the duodenum suggesting the presence of a distal duodenal stricture resulting from the known recurrent tumor. To palliate this intestinal obstruction, we successfully placed an expandable metal stent(EMS) using a double-balloon enteroscope(DBE), which achieved immediate relief of the obstruction and enabled the resumption of oral intake and chemotherapy. While the endoscopic placement of an EMS is available for malignant gastro-intestinal obstruction, it is considerably more difficult to approach the duodenum with Roux-en-Y anastomosis. A DBE has made it possible to place an EMS deep in the small intestine. In the present case, this minimally invasive procedure avoided the need for surgery and greatly contributed to palliation. Thus, EMS placement using a DBE is a possible palliative treatment for malignant small bowel obstruction.

Original languageEnglish
Pages (from-to)2372-2374
Number of pages3
JournalGan to kagaku ryoho. Cancer & chemotherapy
Volume39
Issue number12
Publication statusPublished - Nov 2012
Externally publishedYes

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Roux-en-Y Anastomosis
Duodenal Obstruction
Endoscopes
Stents
Metals
Intestinal Obstruction
Duodenum
Gastric Stump
Drug Therapy
Colic
Palliative Care
Ligaments
Small Intestine
Stomach Neoplasms
Dilatation
Pathologic Constriction
Recurrence
Pain
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

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title = "[Stent placement using a double-balloon endoscope for malignant duodenal obstruction with Roux-en-Y Anastomosis-a case report].",
abstract = "A 79-year-old man who had previously undergone partial resection of the remnant stomach and Roux-en-Y reconstruction was diagnosed as having peritoneal recurrence near the ligament of Treitz. In the course of chemotherapy for recurrent gastric cancer, he complained of colic pain. CT examination revealed a marked dilation of the duodenum suggesting the presence of a distal duodenal stricture resulting from the known recurrent tumor. To palliate this intestinal obstruction, we successfully placed an expandable metal stent(EMS) using a double-balloon enteroscope(DBE), which achieved immediate relief of the obstruction and enabled the resumption of oral intake and chemotherapy. While the endoscopic placement of an EMS is available for malignant gastro-intestinal obstruction, it is considerably more difficult to approach the duodenum with Roux-en-Y anastomosis. A DBE has made it possible to place an EMS deep in the small intestine. In the present case, this minimally invasive procedure avoided the need for surgery and greatly contributed to palliation. Thus, EMS placement using a DBE is a possible palliative treatment for malignant small bowel obstruction.",
author = "Masahiko Oiwa and Shunsuke Kagawa and Hiroyuki Kishimoto and Futoshi Uno and Masahiko Nishizaki and Aiko Kono and Toshiyoshi Fujiwara",
year = "2012",
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T1 - [Stent placement using a double-balloon endoscope for malignant duodenal obstruction with Roux-en-Y Anastomosis-a case report].

AU - Oiwa, Masahiko

AU - Kagawa, Shunsuke

AU - Kishimoto, Hiroyuki

AU - Uno, Futoshi

AU - Nishizaki, Masahiko

AU - Kono, Aiko

AU - Fujiwara, Toshiyoshi

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N2 - A 79-year-old man who had previously undergone partial resection of the remnant stomach and Roux-en-Y reconstruction was diagnosed as having peritoneal recurrence near the ligament of Treitz. In the course of chemotherapy for recurrent gastric cancer, he complained of colic pain. CT examination revealed a marked dilation of the duodenum suggesting the presence of a distal duodenal stricture resulting from the known recurrent tumor. To palliate this intestinal obstruction, we successfully placed an expandable metal stent(EMS) using a double-balloon enteroscope(DBE), which achieved immediate relief of the obstruction and enabled the resumption of oral intake and chemotherapy. While the endoscopic placement of an EMS is available for malignant gastro-intestinal obstruction, it is considerably more difficult to approach the duodenum with Roux-en-Y anastomosis. A DBE has made it possible to place an EMS deep in the small intestine. In the present case, this minimally invasive procedure avoided the need for surgery and greatly contributed to palliation. Thus, EMS placement using a DBE is a possible palliative treatment for malignant small bowel obstruction.

AB - A 79-year-old man who had previously undergone partial resection of the remnant stomach and Roux-en-Y reconstruction was diagnosed as having peritoneal recurrence near the ligament of Treitz. In the course of chemotherapy for recurrent gastric cancer, he complained of colic pain. CT examination revealed a marked dilation of the duodenum suggesting the presence of a distal duodenal stricture resulting from the known recurrent tumor. To palliate this intestinal obstruction, we successfully placed an expandable metal stent(EMS) using a double-balloon enteroscope(DBE), which achieved immediate relief of the obstruction and enabled the resumption of oral intake and chemotherapy. While the endoscopic placement of an EMS is available for malignant gastro-intestinal obstruction, it is considerably more difficult to approach the duodenum with Roux-en-Y anastomosis. A DBE has made it possible to place an EMS deep in the small intestine. In the present case, this minimally invasive procedure avoided the need for surgery and greatly contributed to palliation. Thus, EMS placement using a DBE is a possible palliative treatment for malignant small bowel obstruction.

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