title: Covered expandable metallic stent placement for hemostasis of colonic bleeding caused by invasion of gallbladder carcinoma.
abstract: A 72-year-old Japanese man was admitted to our hospital complaining of right upper-quadrant abdominal pain, blood in his stool, and symptoms of anemia. On physical examination a hard mass, about 6 cm in diameter, was palpable in the right upper quadrant of the abdomen. Computed tomography revealed a gallbladder carcinoma which had invaded the transverse colon, with liver metastasis. We diagnosed gallbladder carcinoma, stage IVB. Colonoscopy was performed for persistent blood in the stools. This revealed an elevated lesion which appeared to be an invasion of gallbladder carcinoma, with diffuse bleeding from the right-side of the transverse colon. It proved difficult to stop this bleeding by ordinary therapeutic endoscopy. In order to achieve hemostasis we therefore inserted a covered Ultraflex metallic stent to compress the tumor. After stent placement, blood was no longer seen in the patient's stools, he became able to eat soft food and was discharged. This treatment was uninvasive and effective. Covered stent placement appears to be a new and useful method in the management of bleeding from malignant gastrointestinal tumors.
authors.affiliation: Department of Internal Medicine, Tosei General Hospital, Seto, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Hasegawa
authors.forename: K
authors.initials: K
authors.lastname: Kato
authors.forename: K
authors.initials: K
authors.lastname: Morita
authors.forename: M
authors.initials: M
authors.lastname: Kuroiwa
authors.forename: M
authors.initials: M
authors.lastname: Shinkai
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: T
authors.initials: T
authors.lastname: Kamioka
authors.forename: H
authors.initials: H
authors.lastname: Otagiri
authors.forename: Y
authors.initials: Y
authors.lastname: Shindo
authors.forename: H
authors.initials: H
authors.lastname: Goto
mesh_terms: D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003113:Colonoscopy; D017809:Fatal Outcome; D005706:Gallbladder Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D015607:Stents; D014057:Tomography, X-Ray Computed