Clin Endosc.  2014 Sep;47(5):415-419. 10.5946/ce.2014.47.5.415.

Colonic Stent-Related Complications and Their Management

• Han SH
• Lee JH

• KMID: 2165372
• DOI: http://doi.org/10.5946/ce.2014.47.5.415

Abstract

Since its introduction in the early 1990s, the self-expandable metal stent (SEMS) has been increasingly used for the management of malignant colorectal obstruction, not only as a palliative method but also as a preoperative treatment in surgical candidates. However, more recently, concerns have been raised over stent complication rates. Early complications include pain, perforation, and rectal bleeding, and late complications include stent migration and stent obstruction. With the increasing use of SEMS for treatment, physicians need to be more aware of complications occurring after the placement of these stents. This review covers the technical considerations and management of complications after colonic stenting.

Keyword

Colon; Stents; Complications

MeSH Terms

Colon*
Hemorrhage
Stents

Figure

• 

  Fig. 1 (A) Abdominal radiograph of a 48-year-old woman with metastatic colonic carcinoma and local invasion who presented with acute colonic obstruction. Palliative decompression was offered because of her poor general condition and high surgical risk. (B) Radiograph obtained immediately after stent deployment showing partial expansion of the stent (arrow), with adequate flow of contrast material. (C) Abdominal radiograph obtained 24 hours after stent deployment showing decompression of the colonic obstruction; adequate position of the stent is noted.

• 

  Fig. 2 (A) Abdominal radiograph of an 82-year-old patient who presented with acute colonic obstruction with advanced gastric cancer, seeding metastasis, and segmental rectal wall thickening. (B) Palliative decompression was offered by means of rectal stenting. (C) However, the symptom was not resolved because of the seeding metastasis.

• 

  Fig. 3 (A) Abdominal radiograph of a female patient with signs of reobstruction such as abdominal pain and nausea. She underwent a palliative procedure and her symptoms were relieved. (B) However, the stent migrated after 2 months. She again presented symptoms of reobstruction. (C) Restenting was done and the symptoms were relieved.

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