The Great View Forward: The Use of a Colonoscope for Distal Duodenal Stent Placement

Dig Dis Sci. 2019 Sep;64(9):2445-2448. doi: 10.1007/s10620-019-05768-3.

Abstract

Introduction: Stent placement in the distal duodenum can be difficult. We describe a case report of a 94-year-old man with metastatic pancreatic head cancer compressing the third and fourth portions of the duodenum, treated by endoscopic stent placement using a colonoscope.

Areas covered: A literature review highlighted two possible procedures for stent placement in the distal duodenum, namely forward-viewing and side-viewing endoscopies. Gastroscopes, duodenoscopes, enteroscopes, and colonoscopes have all been suggested for the purpose. For distal lesions, especially when the duodenal wall is stiffened due to compression or infiltration by neoplastic lesions, a conventional upper endoscope can be too short to reach the narrowed site in "push mode," necessitating the use of a longer endoscope.

Expert commentary: A colonoscope can be safely and effectively used to accomplish distal duodenal stent placement.

Keywords: Duodenal obstruction; Endoscopy; Palliation; Pancreatic cancer; Stents.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Colonoscopes*
  • Duodenal Diseases / etiology
  • Duodenal Diseases / surgery*
  • Duodenoscopy / instrumentation*
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery*
  • Male
  • Palliative Care
  • Pancreatic Neoplasms / complications*
  • Pancreatic Neoplasms / secondary
  • Prosthesis Implantation / instrumentation*
  • Self Expandable Metallic Stents