title: Reocclusion after Self-Expandable Metallic Stent Placement for Relieving Malignant Colorectal Obstruction as a Palliative Treatment.
abstract: Self-expandable metallic stent (SEMS) placement has been practiced in several hospitals in Japan, including ours, since January 2012. Here, we report the case of an 82-year-old Japanese man who presented to the hospital with a 1-week history of right hypochondrial pain. Computed tomography (CT) findings indicated colorectal cancer. The laboratory findings on admission indicated severe anemia (red blood cell count, 426 × 104/μL; hemoglobin, 7.9 g/dL). We performed SEMS placement because the patient refused to undergo surgery. He did not attend any of the scheduled follow-up visits after SEMS placement. However, a year and a half after the SEMS placement, the patient attended the hospital because of difficulty in passing stool. A plain abdominal CT scan showed bowel reobstruction due to the ascending colon cancer after SEMS placement. We performed an emergency operation, ascending colostomy, on the same day. Colorectal stent placement may be a good treatment option for patients who refuse to undergo conventional therapeutic treatments or in those with unresectable colorectal cancer. Patients should be carefully followed up every few months after SEMS placement because of the risk of reocclusion.
authors.affiliation: Division of Surgery, Gastroenterological Center, Medico Shunjyu Shiroyama Hospital, Habikino City, Japan.
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Nitta
authors.affiliation: Division of Surgery, Gastroenterological Center, Medico Shunjyu Shiroyama Hospital, Habikino City, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Division of Internal Medicine, Gastroenterological Center, Medico Shunjyu Shiroyama Hospital, Habikino City, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Division of Surgery, Gastroenterological Center, Medico Shunjyu Shiroyama Hospital, Habikino City, Japan.
authors.forename: Tomo
authors.initials: T
authors.lastname: Tominaga
authors.affiliation: Division of Surgery, Gastroenterological Center, Medico Shunjyu Shiroyama Hospital, Habikino City, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Division of Surgery, Gastroenterological Center, Medico Shunjyu Shiroyama Hospital, Habikino City, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawasaki
authors.affiliation: Division of Internal Medicine, Gastroenterological Center, Medico Shunjyu Shiroyama Hospital, Habikino City, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kawakami
authors.affiliation: Division of Surgery, Gastroenterological Center, Medico Shunjyu Shiroyama Hospital, Habikino City, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishibashi
keywords: Malignant colorectal obstruction; Palliative treatment; Reocclusion; Self-expandable metallic stent placement