Palliative treatment of recurrent obstructing gastric cancer. A case report of successful treatment with three self-expanding metallic stents.
Patients with advanced or recurrent gastric cancer affecting the upper and lower gastrointestinal tract usually experience obstructive symptoms, causing a severe compromise in their quality of life. Surgery may not be feasible because of the patient's precarious medical condition and multilevel tumor infiltration. When faced with these circumstances, surgeons have few options. Parenteral nutrition and comfort measures are utilized when surgical bypass is not a tenable option. We herein describe a unique case of multilevel upper and lower gastrointestinal obstruction secondary to recurrent gastric cancer. The patient was treated palliatively through a combined surgical, radiological, and endoscopic approach by implanting a series of self-expanding metallic stents. To our knowledge, there are no previous reports of successful management of simultaneous strictures of the upper and lower gastrointestinal tract using this technique.
Bernik
T R
TR
Department of Surgery, Saint Vincents Hospital, 170 West 12th Street, New York, NY, USA. bernik@earthlink.net
Bernik
S F
SF
Morgenstern
B R
BR
Pindyck
F
F
Wallack
M K
MK
D004724:Endoscopy / Q000379:methods; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery / Q000628:therapy*; D012008:Recurrence; D015607:Stents / Q000706:statistics & numerical data*; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery* / Q000628:therapy*