Wu Yu, Li Xi, Xiong Fei, Bao Wei-Dong, Dai Yong-Zhou, Yue Lin-Jun, Liu Yuan
Department of Interventional Oncology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China.
World J Clin Cases. 2022 Nov 6;10(31):11529-11535. doi: 10.12998/wjcc.v10.i31.11529.
Malignant tumors of the ileocecal region often cause intestinal obstruction. Emergency surgery is the main treatment for patients presenting with an obstruction. However, this procedure is associated with a high mortality rate and frequent complications. The placement of colon stents is commonly performed for obstructions in the distal colon and is a less invasive and safer procedure. However, obstructions in the proximal colon are more challenging to treat by stent placement due to the increased distance from the anus.
This case report concerns an 88-year-old man with malignant intestinal obstruction in the ileocecal region. He was contraindicated for general anesthesia and surgical enterostomy. The placement of a self-expandable metallic stent seems an alternative to surgery, although stenting in this area is thought to be difficult and few studies have been reported so far. After three attempts at different interventional approaches, a stent was successfully placed in the obstructed segment under fluoroscopic guidance. After the procedure, the patient's abdominal distension and abdominal pain were significantly better than before.
For patients with proximal colonic obstruction, self-expandable metallic stent placement under fluoroscopic guidance could be considered as a feasible treatment to relieve abdominal distension and pain in patients with acute bowel obstruction. It has the characteristics of high safety and high patient tolerance. However, further study is still needed.
回盲部恶性肿瘤常导致肠梗阻。急诊手术是肠梗阻患者的主要治疗方法。然而，该手术死亡率高且并发症频发。结肠支架置入术常用于治疗远端结肠梗阻，是一种侵入性较小且更安全的手术。然而，由于距肛门距离增加，近端结肠梗阻通过支架置入术治疗更具挑战性。
本病例报告涉及一名88岁回盲部恶性肠梗阻男性患者。他因全身麻醉和手术造口术存在禁忌证。尽管在此区域置入支架被认为困难且目前报道的研究较少，但自膨式金属支架置入术似乎是手术的一种替代方法。经过三种不同介入方法的三次尝试后，在透视引导下成功将支架置入梗阻段。术后，患者腹胀和腹痛明显较术前好转。
对于近端结肠梗阻患者，透视引导下自膨式金属支架置入术可作为缓解急性肠梗阻患者腹胀和疼痛的一种可行治疗方法。它具有安全性高和患者耐受性高的特点。然而，仍需进一步研究。
