Key points
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Self-expanding metal stents safely allow both palliative and bridge-to-surgery treatment of obstructing colorectal carcinomas
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Stenting of benign colorectal disorders is mostly reserved for selected refractory anastomotic strictures and post-surgical leaks
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With appropriate reconstructions, CT provides a comprehensive high-resolution visualisation of the stent, the treated colonic disease and surrounding structures
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CT is the technique of choice to comprehensively investigate patients with clinical suspicion of stent-related complications
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The commonest stent-related complications include misplacement, haemorrhage, perforation, migration and re-obstruction
Introduction
Indication | |
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Palliation of colorectal carcinoma (CRC)-related bowel obstruction In non-operative candidates Non-resectable malignant stricture Local postoperative neoplastic recurrence | |
Preoperative decompression in obstructing resectable CRC (bridge-to-surgery) | |
Relief of large bowel obstruction from extracolonic malignancy, pelvic mass or peritoneal carcinomatosis | |
Malignant colorectal fistula, e.g. to the urinary bladder or vagina | |
Postoperative anastomotic leakage/fistula |
Colonic stenting: technical basics
Stents in the management of colorectal carcinoma
Palliation of malignant large bowel obstruction
Stenting as a “bridge to surgery”
Stent management of extracolonic malignancies
Stent management of benign colonic disorders
Stent management of post-surgical colorectal complications
Imaging of colonic stents
Pre-procedural imaging
Post-procedural radiographs
CT techniques and role
MRI of colonic stents
Imaging of stent-related complications
Early complications | Late complications |
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Technical failure | Stent migration |
Stent misplacement/failed relief of obstruction | Re-obstruction |
Haemorrhage | (Chemotherapy-related) perforation |
Stent migration | Fistulisation |
Perforation |