Auspicious Management of a Acute Obstructive Left Colon Tumor in a 93-year-old Patient - Case Report and Literature Review

Chirurgia (Bucur). 2017 Nov-Dec;112(6):734-746. doi: 10.21614/chirurgia.112.6.734.

Abstract

We present the case of a 93-year-old patient with intestinal occlusion due to a descending colon tumor, with carcinomatous ascites and secondary liver and lung determinations. Considering the risks associated with a surgical act in such a patient and the impossibility of performing a curative intervention, a self-expanding metallic colonic stent was mounted. The post-intervention evolution was favorable, the patient being discharged 48 hours later. Left colon cancer is diagnosed in the occlusive phase in 8 to 26% of cases (1). It often requires an immediate surgical resolution due to the potential risk of death. Emergency surgery involves increased rates of morbidity and mortality (2). Thus, other ways of resolving these surgical emergencies have been developed. Colonic stents were first reported in the literature by Dohmoto (3). Initially, the use of stents was as the final method of palletising (4). Later, they were used as a bridge to minimally invasive programmed surgery (5).

Keywords: bowelobstruction; descendingcolontumor; self-expandingmetalliccolonicstent.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Ascites / etiology
  • Carcinoma / complications
  • Carcinoma / diagnosis
  • Carcinoma / secondary
  • Carcinoma / therapy*
  • Colon, Descending / pathology
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / therapy*
  • Emergency Treatment / methods
  • Frail Elderly
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / therapy*
  • Liver Neoplasms / complications
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / secondary
  • Lung Neoplasms / therapy*
  • Male
  • Palliative Care* / methods
  • Prognosis
  • Risk Factors
  • Self Expandable Metallic Stents*
  • Treatment Outcome