Palliation of pyloric stenosis caused by gastric cancer using an endoscopically placed covered ultraflex stent: covered stent inside an occluded uncovered stent.
A 71-year-old man developed pyloric stenosis caused by gastric cancer. Vomiting and nausea resolved after the insertion of an uncovered Ultraflex stent (length 10 cm, inner diameter 18-23 mm) through a 7-cm-long stenosis, and the patient was able to eat a soft diet. After 6 weeks, stent occlusion occurred due to tumor ingrowth and accumulation of food residue. Endoscopic observation showed a very narrow residual lumen. A covered Ultraflex stent (length 10 cm, inner diameter 18-23 mm) was inserted through the first stent and expanded to its maximum diameter over the next 2 days. The patient's vomiting and nausea improved rapidly. He died 6 months after the second stenting procedure, from metastatic tumor spread, having remained free of nausea and vomiting. In this case, a covered metallic stent prevented tumor ingrowth and maintained gastrointestinal patency.
Nakamura
T
T
Department of Gastroenterology, Hamamatsu Medical Center, 328 Tomitsuka-cho, Hamamatsu, Shizuoka 432-8580, Japan. toshinakamura@hmedc.or.jp
Kitagawa
M
M
Takehira
Y
Y
Yamada
M
M
Nishiwaki
Y
Y
Nakamura
H
H
D000368:Aged; D020099:Coated Materials, Biocompatible; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008670:Metals; D010166:Palliative Care / Q000379:methods; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000295:instrumentation*; D011707:Pyloric Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery
D020099:Coated Materials, Biocompatible; D008670:Metals