Snapshot quiz 16/1
Authors: B L Skelly, A L Gidwani and Z Mzimba
A 58-year-old woman with iron deficiency anaemia was diagnosed with a stricturing adenocarcinoma of the distal transverse colon at colonoscopy. CT revealed hepatic and peritoneal metastases. She proceeded to therapeutic colonic stenting. Within hours of stenting she complained of new abdominal pain and had generalized peritonism. At laparotomy the stent was found perforated through the distal transverse colon at the site of the carcinoma. The affected segment was resected with the perforated stent in situ and an end colostomy fashioned. The patient proceeded to palliative oncological follow-up. A recent Cochrane review (1) suggests a 5·9 per cent risk of colonic perforation following therapeutic stenting.
1 Sagar J. Colorectal stents for the management of malignant colonic obstructions. Cochrane Database Syst Rev 2011; (11)CD007378.