Glover Caleb M, Bowen Adam, Russell Claire, Rida Ali, Davies Alexandra, Cay Edward, Walling John
Internal Medicine, McLaren Greater Lansing, Lansing, USA.
Gastroenterology, McLaren Greater Lansing, Lansing, USA.
Cureus. 2025 Mar 14;17(3):e80569. doi: 10.7759/cureus.80569. eCollection 2025 Mar.
Gastric outlet obstruction (GOO) secondary to malignant bowel obstruction (MBO) presents significant challenges in patients with advanced cancer, often impairing quality of life and nutritional intake. This report discusses a complex case of a 53-year-old male patient with stage IV colon cancer who developed an aortoenteric fistula (AEF) as a rare, life-threatening complication following duodenal stenting for GOO management. The case highlights the multifaceted etiology of AEF, involving prior radiation, chronic inflammation, and infected psoas abscess, culminating in massive gastrointestinal hemorrhage. While duodenal stents effectively restore luminal patency and alleviate symptoms in palliative settings, vigilant monitoring is crucial to promptly identifying and addressing potential complications, such as AEF. This underscores the need for a multidisciplinary approach in managing GOO in malignancy, balancing the benefits of self-expandable metallic stents (SEMS) against alternative interventions such as gastrojejunostomy (GJ), tailored to the patient's condition and prognosis to optimize outcomes and enhance quality of life.
继发于恶性肠梗阻（MBO）的胃出口梗阻（GOO）给晚期癌症患者带来了重大挑战，常常损害生活质量和营养摄入。本报告讨论了一例复杂病例，一名53岁的男性IV期结肠癌患者，在十二指肠支架置入术治疗GOO后，发生了一种罕见的、危及生命的并发症——主动脉肠瘘（AEF）。该病例突出了AEF的多方面病因，包括既往放疗、慢性炎症和感染性腰大肌脓肿，最终导致大量胃肠道出血。虽然十二指肠支架在姑息治疗中能有效恢复管腔通畅并缓解症状，但密切监测对于及时识别和处理潜在并发症（如AEF）至关重要。这强调了在恶性肿瘤患者GOO管理中采用多学科方法的必要性，权衡自膨式金属支架（SEMS）与诸如胃空肠吻合术（GJ）等替代干预措施的益处，根据患者的病情和预后进行定制，以优化治疗效果并提高生活质量。
