Endoscopy 2000; 32(6): 495-497
DOI: 10.1055/s-2000-644
Case Report
Georg Thieme Verlag Stuttgart ·New York

Duodenal Perforation by a Wallstent

V.  K.  Thumbe 1 , A.  D.  Houghton 1 , M.  S. H.  Smith 2
  • 1 Dept. of Surgery, Royal Shrewsbury Hospital NHS Trust, Shrewsbury, UK
  • 2 Dept. of Gastroenterology, Royal Shrewsbury Hospital NHS Trust, Shrewsbury, UK
Further Information

Publication History

Publication Date:
31 December 2000 (online)

Endoscopic and/or radiological insertion of metallic mesh stents has recently been described as an alternative to palliative bypass operation in patients with gastric outlet obstruction caused by advanced malignant disease. We report a complication caused by migration and late perforation of the duodenum by a Wallstent, which raised concerns about the place of this procedure as an alternative to surgical bypass. The Wallstents have sharp ends and could cause ulcers or perforation of the viscus. Modification of the current Wallstent design may be needed.

References

  • 1 Feretis C, Benakis P, Dimopoulos C, et al. Duodenal obstruction caused by pancreatic head carcinoma: palliation with self-expandable endoprostheses.  Gastrointest Endosc. 1997;  46 161-165
  • 2 Binkert C A, Jost R, Steiner A, Zollikofer C L. Benign and malignant stenoses of the stomach and duodenum: treatment with self expanding metallic endoprostheses.  Radiology. 1996;  199 335-338
  • 3 Domschke W, Foerster E C, Matek M, Rodl W. Self expanding mesh stents for esophageal cancer stenosis.  Endoscopy. 1990;  22 134-136
  • 4 Knyrim K, Wagner H J, Stark E, et al. A prospective randomized trial of expandable metal stents in malignant biliary obstruction (abstract).  Gastroenterology. 1992;  102 A318
  • 5 Tejero E, Fernandez-Lobato R, Mynar A, et al. Initial results of a new procedure for treatment of malignant obstruction of the left colon.  Dis Colon Rectum. 1997;  40 432-436
  • 6 Potts J R, Broughan T A, Hermann R E. Palliative operations for pancreatic carcinoma.  Am J Surg. 1990;  159 72-79
  • 7 Nagy A, Brosseuk D, Hemming A, et al. Laparoscopic gastroenterostomy for duodenal obstruction.  Am J Surg. 1995;  169 539-542
  • 8 Scott-Mackie P, Morgan R, Farrugia M, et al. The role of metallic stents in malignant duodenal obstruction.  Br J Radiol. 1997;  70 252-255
  • 9 De Baere T, Harry G, Ducreux M, et al. Self expanding metallic stents as palliative treatment of malignant gastroduodenal stenosis.  Am J Roentgenol. 1997;  169 1079-1083
  • 10 Davies N H, McCall J. Transhepatic placement of combined biliary and duodenal stents.  Am J Roentgenol. 1999;  172 57-58
  • 11 Langhorne N B, Asch M R, Jaffer N. Palliation of gastrointestinal obstruction with expandable metallic stents.  Can Assoc Radiol J. 1997;  48 327-332

M. S. H. Smith, M.D., M.R.C.P.

Dept. of Gastroenterology Royal Shrewsbury Hospital NHS Trust

Mytton Oak Road Shrewsbury SY3 8XQ UK

Fax: Fax:+ 44-1743-261066

Email: E-mail:Smithmsh@AOL.com