ENDOSCOPIC PLACEMENT OF METALLIC STENT FOR COLONIC STRICTURE RESULTING FROM CARCINOMA LOCATED AT THE SPLENIC FLEXURE

A 67-year-old woman was admitted to Ikuwakai Memorial Hospital with sub-ileus symptoms. Radiographic and endoscopic examination revealed that the patient had a colonic cancer approximately 15 cm in length from the descending colon to the distal transverse colon with severe stricture. The histopathological finding was mucinous adenocarcinoma. Abdominal computed tomography showed multiple liver metastases and intraperitoneal lymph-node swelling. A per-rectal decompression tube was inserted temporarily, and surgical colostomy was initially proposed. However, the patient rejected surgery, and stent therapy was considered as an alternative therapy. An ultraflex esophageal expandable metallic stent was installed. At day 4, tumor projection through the expandable metal-stent mesh was observed and additional balloon dilatation was carried out under colonoscopic assistance. At day 7, ileus symptoms disappeared and the patient had been able to maintain oral feeding for 3 months until she died as a result of cachexia by systemic metastasis of colonic cancer.