A newly designed duodenal stent enables stent placement for jejunal obstruction

A newly designed duodenal stent enables stent placement for jejunal obstruction An 80-year-old woman who had undergone surgery for pancreatic tail cancer received chemotherapy for peritoneal dissemination recurrence, but the response was poor.She developed vomiting due to stenosis in the ascending part of the duodenum caused by tumor progression ( Fig. 1 a).After decompression with an ileus tube, a duodenal stent was placed ( Fig. 1 b,c), resulting in tempor-ary relief.However, vomiting recurred after two weeks, and computed tomography (CT) revealed a jejunal stenosis approximately 20 cm distal to the ligament of Treitz ( Fig. 2 a,b).An ileus tube was reinserted.Given that the narrowing was confined to a localized segment of the proximal jejunum, stent placement was considered appropriate.A colonoscope (CF-H260; Olympus, Tokyo, Japan) was used.A catheter and a 0.025-inch guidewire (GW) were inserted through the existing stent ( Video 1).Contrast imaging showed a stenosis 3 cm in length consistent with CT findings ( Fig. 3 a).A 0.035-inch GW was added to enhance stent deliverability.Two duodenal stents (22 mm 12 cm and 22mm8cm; JENTLLY NEO Duodenal Stent; Japan Lifeline, Tokyo, Japan) were selected to prevent kinking ( Fig. 3 b).Both showed good trackability.The stents were accurately placed, and contrast confirmed adequate distal flow ( Fig. 3 c).Postoperatively, ileus tube drainage decreased, and CT showed improvement in dilatation ( Fig. 4 a-c).The patient resumed oral intake.