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Acute endometrial bowel obstruction-A rare indication for colonic stenting.
MedLine Citation:
PMID:  23276756     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Pelvic endometriosis is an extremely rare cause of large bowel obstruction and the management can be challenging. Urgent surgery for acute colonic obstruction is known to carry high morbidity and mortality, and operation may be made more difficult in extensive pelvic endometriosis. Less invasive alternatives in the acute situation may need to be considered.
PRESENTATION OF CASE: Presented is the case of a 35-year-old lady with obstructive bowel symptoms caused by an endometriotic upper rectal stricture. She was initially treated using radiologically guided stent insertion, as an acute intervention, prior to an elective bowel resection and hysterectomy with bilateral salpingo-oophorectomy.
DISCUSSION: Colonic stenting is currently widely used in malignant obstruction. The use of self expanding metallic stents (SEMS) to treat benign conditions is controversial, however, due to associated long term complications. This case demonstrates that stenting can provide a bridge to major surgery in the rare event of acute endometriotic colonic obstruction. The initial acute treatment with stenting provides the advantage of time to involve the multi-disciplinary team, to medically optimise the patient and to better plan the definitive surgery.
CONCLUSION: The use of radiologically guided stents has a place in the treatment of benign recto-sigmoid obstruction due to endometriosis and therefore should be considered as a bridge to further surgical treatment.
Authors:
Christopher Whelton; Arnab Bhowmick
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Publication Detail:
Type:  Journal Article     Date:  2012-11-26
Journal Detail:
Title:  International journal of surgery case reports     Volume:  4     ISSN:  2210-2612     ISO Abbreviation:  Int J Surg Case Rep     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-14     Completed Date:  2013-01-15     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  101529872     Medline TA:  Int J Surg Case Rep     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  160-3     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Affiliation:
University of Manchester, United Kingdom. Electronic address: crwhelton@doctors.org.uk.
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