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Orii T, Karasawa Y, Kitahara H, et al. Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer. Case Rep Gastroenterol. 2016;10(1):151-6doi: 10.1159/000445738.
Orii, T., Karasawa, Y., Kitahara, H., Yoshimura, M., & Okumura, M. (2016). Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer. Case reports in gastroenterology, 10(1), 151-6. https://doi.org/10.1159/000445738
Orii, Takashi, et al. "Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer." Case reports in gastroenterology vol. 10,1 (2016): 151-6. doi: https://doi.org/10.1159/000445738
Orii T, Karasawa Y, Kitahara H, Yoshimura M, Okumura M. Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer. Case Rep Gastroenterol. 2016 May 02;10(1):151-6. doi: 10.1159/000445738. eCollection 2016. PMID: 27403118; PMCID: PMC4929394.
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Case Rep Gastroenterol. 2016 May 02;10(1):151-6. doi: 10.1159/000445738. eCollection 2016.

Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer.

Case reports in gastroenterology

Takashi Orii, Yukihiko Karasawa, Hiroe Kitahara, Masaki Yoshimura, Motohiro Okumura

Affiliations

  1. Department of Surgery, Showa Inan General Hospital, Komagane, Japan.

PMID: 27403118 PMCID: PMC4929394 DOI: 10.1159/000445738

Abstract

Because of advances in the technology of gastrointestinal endoscopy and improvements in the quality of stents, it has become routine to place a stent as palliative therapy for malignant gastrointestinal obstruction. On the other hand, stent placement for malignant gastrointestinal hemorrhage has scarcely been reported, although it may be performed for hemorrhage of the esophageal varicose vein. We recently experienced a patient with refractory hemorrhage from an unresectable duodenal cancer who underwent placement of a self-expandable metallic stent (SEMS) and thereafter had no recurrence of the hemorrhage. A 46-year-old man underwent laparotomy to radically resect a cancer in the third portion of the duodenum, which invaded widely to the superior mesenteric vein and its branches and was considered unresectable. After stomach-partitioning gastrojejunostomy was performed, chemotherapy was initiated according to the regimen of chemotherapy of far advanced gastric cancer. One year and 4 months after induction of chemotherapy, gastrointestinal hemorrhage occurred. Upper gastrointestinal endoscopy revealed the hemorrhage oozing from the duodenal cancer, and endoscopic hemostasis, such as injection of hypertonic saline epinephrine and argon plasma coagulation, was unsuccessful. Twenty days after emergence of the hemorrhage, an endoscopic covered SEMS was placed with confirmation by fluoroscopy. Immediately after placement of the stent, the tarry stool stopped and the anemia ceased to progress. The recurrence of the hemorrhage has not been confirmed without migration of the stent. SEMS is an effective hemostatic procedure for malignant refractory hemorrhage.

Keywords: Duodenal cancer; Malignant gastrointestinal tract hemorrhage; Self-expandable metallic stent

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