A case of perforation and fistula formation resulting from metallic stent for sigmoid colon stricture in Crohn’s disease

摘要

A 52-year-old male was diagnosed with Crohn’s disease at the age of 25 years. Thereafter, he underwent three operations for intestinal strictures or fistula. A self-expanding metallic stent was inserted into the sigmoid colon stricture endoscopically in November 1999. Thirty two months later, he presented left lower abdominal pain. Endoscopic and radiographic examinations demonstrated perforation of the stent and ileosigmoid fistula. Laparotomy revealed an inflammatory mass around the sigmoid colon, and the wire frame of the metallic stent had penetrated the colonic wall and had fistulized to the ileum. The affected sigmoid colon was resected and low anterior resection and ileostomy were performed. Metallic stent for intestinal stricture of Crohn’s disease with active ulceration may postpone surgery temporarily but can be a potentially dangerous procedure.