Curbside Consultation in GI Cancer for the Gastroenterologist: 49 Clinical Questions

Douglas G. Adler, MD

Question 43: A 78-Year-Old Man With Metastatic Colon Cancer Had A Colonic Stent Placed 16 Months Ago. He Has Developed Recurrent Obstruction At The Site Of The Tumor. How Should This Patient Be Evaluated And Managed? (continued)

Waqar A. Qureshi, MD; Yasser H. Shaib, MD, MPH, FASGE

This patient had a colonic stent placed for palliation of metastatic colon cancer 16 months ago. He appears to have done very well but now presents with obstruction at the site to the initial tumor. Self-expanding metal stents (SEMS) are placed in the colon for 2 main indications: 1. Palliation in cases of advanced (metastatic) or inoperable colon cancer presenting with bowel obstruction. This group may also include patients with other comorbidities who cannot undergo surgery. 2. As a bridge to elective surgery in patients who present with malignant colon obstruction but are too sick to go…