title: [A Case of Malignant Colonic Obstruction Bearing Another Synchronous Obstructive Lesion in the Anal Side of the Colon].
abstract: There are several reasons for failure in the insertion of a self-expandable metallic stent(SEMS)into a malignant colonic obstruction(MCO)including difficulty in insertion of the catheter or guidewire through the stenotic lumen into the oral side or perforation relatedto the technique. Herein, we report a case of MCO bearing another synchronous obstructive lesion in the anal side of the colon that couldhave explainedthe difficulty in the insertion of the SEMS into the stenosis locatedin the oral side, which might have indicated the need for an emergency operation for relieving the obstruction. A 76-year-oldman with epigastralgia andmelena was admittedto our hospital andhe was diagnosedwith a MCO in the ascending colon. A series of examinations performedafter admission revealedthat the patient hadanother synchronous obstructive lesion in the descending colon, which made colonoscope insertion at the oral side difficult. The next day after admission, we observed that fasting relievedthe patient from abdominal pain causedby obstruction; therefore, we performedSEMS insertion into the MCO of the descending colon followed by SEMS insertion into the ascending colon after 6 days. These serial SEMS insertions facilitated the oral administration of the diet and the patient was discharged 15 days after admission. The patient was readmittedto our hospital andhe underwent a radical operation for both lesions in June 2015.
authors.affiliation: Dept. of Surgery, Tokyo Women's Medical University Medical Center East.
authors.forename: Minoru
authors.initials: M
authors.lastname: Murayama
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
authors.forename: Satoko
authors.initials: S
authors.lastname: Murakami
authors.forename: Katsuo
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Koizumi
authors.forename: Asako
authors.initials: A
authors.lastname: Shimazaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Asaka
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Hajime
authors.initials: H
authors.lastname: Yokomizo
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshimatsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimakawa
authors.forename: Takao
authors.initials: T
authors.lastname: Katsube
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naritaka
mesh_terms: D000368:Aged; D001004:Anus Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000628:therapy; D003110:Colonic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D045823:Ileus / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000628:therapy; D008297:Male; D015607:Stents