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Self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: A case report

INTRODUCTION: The self-expanding metal stent (SEMS) has been used in malignant colorectal obstruction as a bridge to surgery or for palliative treatment. We report a case of obstructive descending colon diverticulitis in-stent restenosis, which is difficult to distinguish from colon cancer. PRESENTA...

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Autores principales: Ohta, Ryo, Sakon, Ryota, Goto, Manabu, Tachimori, Yuji, Sekikawa, Koji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258250/
https://www.ncbi.nlm.nih.gov/pubmed/30445358
http://dx.doi.org/10.1016/j.ijscr.2018.10.073
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author Ohta, Ryo
Sakon, Ryota
Goto, Manabu
Tachimori, Yuji
Sekikawa, Koji
author_facet Ohta, Ryo
Sakon, Ryota
Goto, Manabu
Tachimori, Yuji
Sekikawa, Koji
author_sort Ohta, Ryo
collection PubMed
description INTRODUCTION: The self-expanding metal stent (SEMS) has been used in malignant colorectal obstruction as a bridge to surgery or for palliative treatment. We report a case of obstructive descending colon diverticulitis in-stent restenosis, which is difficult to distinguish from colon cancer. PRESENTATION OF CASE: A 48-year-old man presented with abdominal pain. Computed tomography demonstrated a segment of thickened wall in the descending colon with near-complete obstruction. Colonoscopy revealed stenosis over the entire circumference of the descending colon. Biopsy revealed no malignant findings. SEMS was inserted to improve bowel obstruction. However, bowel obstruction did not improve, and stent-in-stent insertion was performed. Because colon cancer could not be completely excluded, left hemicolectomy with lymph node dissection was performed. The pathological examination revealed colon diverticulitis and no malignant finding. DISCUSSION: Benign colorectal diseases can present with symptoms similar to those of obstructive colorectal cancer. As a result, it was benign colorectal stenosis, but it was thought that resection should be considered when the malignant lesion is suspected. The use of SEMS in benign colorectal disease has been reported a few. Reinsertion of the stent for restenosis, in bridge to surgery, was also considered useful from the viewpoint of avoiding emergent operation and reducing complications. CONCLUSION: For colon stenosis suspected of malignant disease, it was thought that resection by inserting SEMS should be taken into consideration even for benign disease as a result.
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spelling pubmed-62582502018-12-03 Self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: A case report Ohta, Ryo Sakon, Ryota Goto, Manabu Tachimori, Yuji Sekikawa, Koji Int J Surg Case Rep Article INTRODUCTION: The self-expanding metal stent (SEMS) has been used in malignant colorectal obstruction as a bridge to surgery or for palliative treatment. We report a case of obstructive descending colon diverticulitis in-stent restenosis, which is difficult to distinguish from colon cancer. PRESENTATION OF CASE: A 48-year-old man presented with abdominal pain. Computed tomography demonstrated a segment of thickened wall in the descending colon with near-complete obstruction. Colonoscopy revealed stenosis over the entire circumference of the descending colon. Biopsy revealed no malignant findings. SEMS was inserted to improve bowel obstruction. However, bowel obstruction did not improve, and stent-in-stent insertion was performed. Because colon cancer could not be completely excluded, left hemicolectomy with lymph node dissection was performed. The pathological examination revealed colon diverticulitis and no malignant finding. DISCUSSION: Benign colorectal diseases can present with symptoms similar to those of obstructive colorectal cancer. As a result, it was benign colorectal stenosis, but it was thought that resection should be considered when the malignant lesion is suspected. The use of SEMS in benign colorectal disease has been reported a few. Reinsertion of the stent for restenosis, in bridge to surgery, was also considered useful from the viewpoint of avoiding emergent operation and reducing complications. CONCLUSION: For colon stenosis suspected of malignant disease, it was thought that resection by inserting SEMS should be taken into consideration even for benign disease as a result. Elsevier 2018-11-01 /pmc/articles/PMC6258250/ /pubmed/30445358 http://dx.doi.org/10.1016/j.ijscr.2018.10.073 Text en © 2018 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ohta, Ryo
Sakon, Ryota
Goto, Manabu
Tachimori, Yuji
Sekikawa, Koji
Self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: A case report
title Self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: A case report
title_full Self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: A case report
title_fullStr Self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: A case report
title_full_unstemmed Self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: A case report
title_short Self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: A case report
title_sort self-expanding metal stent restenosis in obstructive colon diverticulitis mimicking colon cancer: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258250/
https://www.ncbi.nlm.nih.gov/pubmed/30445358
http://dx.doi.org/10.1016/j.ijscr.2018.10.073
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