Subject(s)
Abscess/diagnostic imaging , Colonic Diseases/diagnostic imaging , Colonic Neoplasms/diagnostic imaging , Fistula/diagnostic imaging , Intestinal Fistula/diagnostic imaging , Portal Vein , Splenic Diseases/diagnostic imaging , Splenic Vein , Thrombosis/diagnostic imaging , Tomography, X-Ray Computed , Abscess/etiology , Aged , Colonic Diseases/etiology , Colonic Neoplasms/complications , Fistula/etiology , Humans , Intestinal Fistula/etiology , Male , Splenic Diseases/etiology , Thrombosis/etiologyABSTRACT
AIM: To report our preliminary experience with self-expandable metal stent in the treatment of acute malignant obstruction of the left colon and to review the literature on this specific subject. PATIENTS AND METHODS: From March to September 1999, 8 consecutive patients with a mean age 71 were admitted as an emergency for acute malignant obstruction of the left colon. A self-expandable metal stent was inserted under radioscopic and, in 4 cases, endoscopic guidance. The patients then underwent bowel preparation before operation, if required. RESULTS: There was no mortality. Bowel preparation was satisfactory in 6 cases. Complications occurred in 1 patient, who was operated on day one for peritonitis due to perforation of the tumour by the prosthesis inserted after dilatation. Another six patients were operated: 2 had resection followed by anastomosis; 3 had resection and anastomosis protected by ileostomy; 2 had Hartmann's procedure. The last patient retained the prosthesis as palliation. In the literature, self-expandable metal stent application in obstructed carcinoma of the left colon gives satisfactory results. CONCLUSION: Based on our experience and a review of the literature, we provide practical recommendations when inserting self-expandable metal stents for acute malignant left colonic obstruction.