A small bowel obstruction due to peritoneal carcinomatosis that was successfully palliated with endoscopic SEMS

Öz

The routine use of self-expandable metallic stents in the palliation of esophageal, biliary system and left-sided colonic neoplasms is well known, but there is only limited evidence that related to the use of self-expandable metallic stents in obstructions due to small bowel neoplasms. Therefore, it is crucial for centers to report their experiences in small bowel obstructions that was treated successfully with endoscopic drainage procedures. We herein would like to share our previous experience in a patient with small bowel obstruction due to peritoneal carcinomatosis that was successfully palliated with endoscopic self-expandable metallic stents replacement, despite its technical difficulties and common failure rates. Although the patients with peritoneal carcinomatosis present with accompanying lesions, external impression and long segment obstruction that leads to difficulties while stent replacement, it can be an acceptable alternative to surgical routes in selected cases.

Anahtar Kelimeler

• Key words: Metallic stent, small bowel obstruction, endoscopic treatment

Metal stent (SEMS) ile palyasyonu sağlanan peritoneal karsinomatozis'e bağlı malign ince barsak tıkanıklığı olgusu

Öz

Kendiliğinden açılabilir metal stentler özellikle özofagus, biliyer sistem ve sol kolon tümörlerinin palyatif tedavisinde rutin olarak kullanılmakla birlikte, benign yada malign sebeplere bağlı ince barsak darlıklarında kullanımı ile ilgili bilgiler kısıtlıdır. Bu nedenle özellikle ince barsak kaynaklı darlıklarda başarılı bir şekilde uygulanan endoskopik drenaj işlemlerinin merkezler tarafından rapor edilmesi büyük önem arz etmektedir. Bu nedenle biz burada endoskopik stentlemenin hem teknik olarak zor hemde sonuçlarının sıklıkla başarısız olduğu peritoneal karsinomatozis'e bağlı ince barsak tıkanıklığı olan ve endoskopik olarak konulan kendiliğinden açılabilir metalik stent ile palyasyonu sağlanan bir olguyu paylaşmak istiyoruz. Her ne kadar peritoneal karsinomatozis hastalarında, eş zamanlı lezyonların varlığı, eksternal bası ve uzun segment tıkanıklık nedeniyle stentleme bazı zorluklar gösterse de sınırlı lokalizasyonu olan seçilmiş vakalarda cerrahi tedavinin makul bir alternatifi olabilir.

Anahtar Kelimeler

• Metalik stent, ince barsak obstrüksiyonu, endoskopik tedavi

Kaynakça

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