Management of Malignant Large-Bowel Obstruction.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• Colorectal cancer is a significant cause of bowel obstruction.
• Endoscopic stenting is a palliative option for malignant colorectal obstruction.
• Iatrogenic complications can occur during endoscopic procedures.

Observation:

• A 59-year-old man presented with symptoms of sigmoid colon obstruction.
• Computed tomography revealed a sigmoid mass; flexible sigmoidoscopy confirmed a distal sigmoid neoplasm.
• Following endoscopic stent placement, the patient developed signs of colon perforation.

Findings:

• The patient underwent an emergent Hartmann procedure for iatrogenic colon perforation.
• The perforation occurred in the context of malignant sigmoid obstruction and proximal colon dilation.
• The patient was otherwise healthy, with a normal CEA level.

Implications:

• This case underscores the potential for serious complications, such as colon perforation, after endoscopic stenting for malignant bowel obstruction.
• Careful patient selection and monitoring are crucial when considering endoscopic stenting.
• Prompt surgical intervention is necessary for managing iatrogenic colon perforations.