Download PDF
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)

Also available at
    Permissions and Reprints

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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 3 Domschke W, Foerster E C, Matek M, Rodl W. Self expanding mesh stents for esophageal cancer stenosis.  Endoscopy. 1990;  22 134-136
    Thieme ConnectPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 6 Potts J R, Broughan T A, Hermann R E. Palliative operations for pancreatic carcinoma.  Am J Surg. 1990;  159 72-79
    PubMedSearch in Google Scholar
  • 7 Nagy A, Brosseuk D, Hemming A, et al. Laparoscopic gastroenterostomy for duodenal obstruction.  Am J Surg. 1995;  169 539-542
    CrossrefPubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 10 Davies N H, McCall J. Transhepatic placement of combined biliary and duodenal stents.  Am J Roentgenol. 1999;  172 57-58
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar

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