Double stenting in advanced colorectal cancer.

1 of 3 DESCRIPTION An 86-year-old woman presented with complete large bowel obstruction secondary to tumour ingrowth of a previously placed enteric stent ( fi gure 1 ). She was deemed not fi t for surgical intervention. A second stent (covered ultrafl ex stent) was inserted through the occluded baremetal stent using a combination of endoscopy and fl uoroscopy ( fi gure 2 ). Recovery was uneventful and CT 4 months later demonstrated stent patency ( fi gure 3 ). In recent years enteric stents are increasingly being used for local palliation in obstructing tumours. They can be utilised as an emergency measure to unblock the bowel with defi nitive surgery carried out electively, avoiding emergency surgery and reducing potential for stoma requirement. They may also be used as a primary treatment in unfi t patients or patients with extensive metastasis. It also offers a faster recovery time (permitting earlier administration of chemotherapy) and a shorter hospital stay. Insertion is generally performed under sedation with the aid of fl uoroscopy/endoscopy. Adverse effects include pain, diarrhoea, urgency, faecal incontinence, rectal bleeding, Images in...