Okugawa Takuya, Oshima Tadayuki, Ikeo Koichi, Kondo Takashi, Tomita Toshihiko, Fukui Hirokazu, Watari Jiro, Miwa Hiroto
Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Case Rep Gastroenterol. 2013 May 18;7(2):214-8. doi: 10.1159/000351818. Print 2013 May.
A 47-year-old woman was diagnosed as having advanced gastric cancer with malignant ascites. Despite chemotherapy, recurrent peritoneal dissemination was seen 1.5 years after operation. A computed tomography scan revealed rectal stenosis due to Schnitzler's metastasis. When the distance from the distal end of the obstruction to the anal verge is less than 5 cm, stent replacement has been said to be contraindicated due to the development of anal pain and foreign body sensation. Although the distance from the distal end of the obstruction to the anal verge was 4 cm in this case, a WallFlex(TM) colonic stent could be placed. She stayed home, and luminal patency remained until she died 270 days after stent insertion. This report demonstrates that rectal obstruction located less than 5 cm from the anal verge due to Schnitzler's metastasis could be treated by stenting without any symptomatic or technical complications.
一名47岁女性被诊断为晚期胃癌伴恶性腹水。尽管接受了化疗，但术后1.5年出现了复发性腹膜播散。计算机断层扫描显示由于施尼茨勒转移导致直肠狭窄。当梗阻远端距肛缘小于5 cm时，据说由于会出现肛门疼痛和异物感，支架置换术被视为禁忌。尽管该病例中梗阻远端距肛缘为4 cm，但仍可置入WallFlex™结肠支架。她居家生活，直到支架置入270天后去世，管腔一直保持通畅。本报告表明，因施尼茨勒转移导致距肛缘小于5 cm的直肠梗阻可通过支架置入治疗，且无任何症状性或技术性并发症。
