Acute abdominal obstruction: Colon stent or emergency surgery? An evidence-based review

Figure 1 Stent models, left to right: Colonic Z (Cook), Evolution colonic (Cook), Wallflex (Boston), D-type colonic not covered (Taewoog), type colonic covered (Taewoong). All FDA approved stents.

Figure 2 Virtual Colonoscopy showing a malignant stricture in the distal left colon.

Figure 3 Radiography images. A: Radiography showing signs of a distal obstruction; B: Radiography of the same patient showing improvement after stenting and decompression. Figure 4 Stents procedure. A: Guide-wire placement through the stricture after contrast study; B: Stent deploying through the scope; C: Stent placement showing the stricture in the middle of the stent; D: Final stent position.

Figure 4 Stents procedure. A: Guide-wire placement through the stricture after contrast study; B: Stent deploying through the scope; C: Stent placement showing the stricture in the middle of the stent; D: Final stent position.

Figure 5 Stent placement by Through the scope technique.

Figure 6 The stent is passed over the guidewire to the proximal margin of the tumor and then implanted under fluoroscopic guidance and endoscopic visualization of the distal portion of the stent. A: Malignant lesion causing colonic stenosis; B: Stent deployment; C: Stent immediately after deployment; D: Fecal contents coming through the stent after decompression.

Figure 7 Stent placement by Over-the-wire technique.

Figure 8 Specimen and stent. A: Specimen after surgery showing the stent crossing the lesion; B: Image of the stent and the malignant lesion after resection.