Duodenal Dilatation and Stenting

What is duodenal stenting?

Usually duodenal stents are placed because of a blockage to the outlet of the stomach often as part of treatment for cancer in that area.

Duodenal stents are made of an expandable wire mesh material called nitinol that is constrained within a narrow plastic sheath. To perform the procedure, the endoscopist passes a soft wire (guidewire) through the narrowing under X-ray guidance. Once the position of the guidewire is confirmed, the narrow stent delivery system is passed through the endoscope over the guidewire and across the stricture under x-ray guidance. The constraining sheath is removed and the stent will expand to allow food to pass out of the stomach.

Duodenal stents are placed whilst the patient is under sedation with the use of a standard endoscope but assisted by x-ray guidance.  The procedure is the same as for a standard endoscopy initially but takes longer, approximately half an hour.

Why would you need a duodenal stent?

The duodenum is the first part of your small bowel, attached to your stomach. The stent is placed across the narrowing or blockage and will expand to allow fluid and food to pass through from your stomach more easily. This will help to reduce symptoms such as vomiting and regurgitation.

How is a duodenal stent placed?

A tube with a camera on the end, called an endoscope, is put in through your mouth and down into the duodenum. A fine wire is then used to guide the stent into place inside the duodenum. The procedure takes 30-40 minutes.

How long can you live with a blocked duodenum?

Average length of time from development of duodenal obstruction to death was 4.8 ± 2.1 months (range 0.5-60 months). Average survival time from diagnosis to death was 16.6 ± 5.6 months (range 4.5-58 months).

What is a duodenal stent made of?

Duodenal stents are made of an expandable wire mesh material called nitinol that is constrained within a narrow plastic sheath. To perform the procedure, the endoscopist passes a soft wire (guidewire) through the narrowing under X-ray guidance.

How big is a duodenal stent?

This stent is an uncovered, braided metallic mesh. Available stents range from 18 to 22 mm in diameter and from 6 to 9 cm in length. The 20- and 22-mm-diameter stents are most commonly used.

What can you eat with a duodenal stent?

On the day your stent is inserted you will be allowed to drink liquids. This includes tea, coffee, milk, soup, jelly, ice cream and any nutritional supplements you have been prescribed. If you manage these without any nausea or vomiting, the following day you can start a soft and moist diet.

What causes a blocked duodenum?

It can occur due to myriad of causes from benign to malignant. The most common etiologies that present as intraluminal obstruction are bezoars and duodenal hematomas, whereas postbulbar peptic ulcer disease, duodenal tuberculosis, and Crohn’s disease may present as luminal pathology like a stricture or stenosis.

What does a duodenal stricture feel like?

Depending on where the stricture is located, patients with strictures can have blockage symptoms that include nausea and vomiting, abdominal pain, bloating, or the inability to pass gas and stool.