Assuntos
Abscesso/diagnóstico por imagem , Doenças do Colo/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Fístula/diagnóstico por imagem , Fístula Intestinal/diagnóstico por imagem , Veia Porta , Esplenopatias/diagnóstico por imagem , Veia Esplênica , Trombose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Abscesso/etiologia , Idoso , Doenças do Colo/etiologia , Neoplasias do Colo/complicações , Fístula/etiologia , Humanos , Fístula Intestinal/etiologia , Masculino , Esplenopatias/etiologia , Trombose/etiologiaRESUMO
AIM: To report our preliminary experience with self-expandable metal stent in the treatment of acute malignant obstruction of the left colon and to review the literature on this specific subject. PATIENTS AND METHODS: From March to September 1999, 8 consecutive patients with a mean age 71 were admitted as an emergency for acute malignant obstruction of the left colon. A self-expandable metal stent was inserted under radioscopic and, in 4 cases, endoscopic guidance. The patients then underwent bowel preparation before operation, if required. RESULTS: There was no mortality. Bowel preparation was satisfactory in 6 cases. Complications occurred in 1 patient, who was operated on day one for peritonitis due to perforation of the tumour by the prosthesis inserted after dilatation. Another six patients were operated: 2 had resection followed by anastomosis; 3 had resection and anastomosis protected by ileostomy; 2 had Hartmann's procedure. The last patient retained the prosthesis as palliation. In the literature, self-expandable metal stent application in obstructed carcinoma of the left colon gives satisfactory results. CONCLUSION: Based on our experience and a review of the literature, we provide practical recommendations when inserting self-expandable metal stents for acute malignant left colonic obstruction.