Palliative use of lumen-apposing metal stents in tandem to alleviate malignant bowel obstructions in a patient with small-bowel adenocarcinoma with carcinomatosis

Q3 Medicine

VideoGIE Pub Date : 2025-05-02 DOI:10.1016/j.vgie.2025.04.009

Smriti Kochhar DO , Ibrahim Yaghnam MD , Abraham Mathew MD

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引用次数: 0

Abstract

Background and Aims

Duodenal stents or endoscopic gastrojejunostomy with lumen-apposing metal stents (LAMSs) are commonly used to treat small-bowel obstruction. However, endoscopic therapy for many regions of obstruction is less well-established. We describe a patient case with multiple areas of obstruction that was relieved with LAMS placement, creating gastroenteric and enteroenteric anastomosis.

Methods

Direct endoscopy with EUS was used to place gastroenteric LAMSs. A multimodal imaging approach, including EUS, fluoroscopy, and transabdominal ultrasound, was used to identify the area of the enteroenteric LAMS. Lastly, a venting percutaneous jejunostomy tube was placed using the transluminal technique.

Results

Tandem LAMS placement successfully decompressed the small bowel with improved oral intake. The patient did not require any hospital readmissions related to the stents.

Conclusions

LAMS placement may be helpful for patients with multiple small-bowel obstructions, especially for patients who are not candidates for surgical intervention to alleviate their symptoms.

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姑息性使用管腔旁置金属支架串联缓解恶性肠梗阻的小肠腺癌伴癌变患者

背景与目的十二指肠支架或内镜下胃空肠造口术联合腔内金属支架（LAMSs）是治疗小肠梗阻的常用方法。然而，内窥镜治疗许多区域的梗阻尚不完善。我们描述了一个病人的情况下，有多个区域的阻塞是缓解与LAMS放置，创造胃肠和肠肠吻合。方法采用EUS直接内镜下放置胃肠道lams。采用多模式成像方法，包括EUS、透视和经腹超声，确定肠肠lam的区域。最后，采用腔内技术置入经皮空肠造瘘管。结果标准LAMS放置成功减压小肠，改善了口服摄入量。该患者不需要任何与支架相关的再入院。结论slams的放置对多发小肠梗阻患者有一定的帮助，特别是对不适合手术治疗的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.