The Use of Endoluminal Stents to Overcome Vascular Obstruction Arising from Mesenteric and Retroperitoneal Neuroendocrine Metastases

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Introduction: Gastroenteropancreatic neuroendocrine tumors (GEP-NET) often metastasise to lymph nodes. Nodal metastases from neuroendocrine tumors in the distal small intestine commonly (>50%) develop in the mesentery and are often centred at the mesenteric root surrounding the major vessels supplying the bowel. Compression of these vessels, by the nodes or associated fibrosis, can lead to severe symptoms such as pain (secondary to bowel ischaemia ), ascites (from superior mesenteric vein obstruction) and bowel perforation. In view of the often indolent nature of GEP-NET, symptoms from lymph node masses can persist for years, causing significant morbidity and early mortality.

Aim(s): We present a case series of patients with significant symptoms arising from such vascular compression who have been treated by the insertion of endoluminal vascular stents. Three patients had rapidly reaccumulating ascites secondary to obstruction of the superior mesenteric vein. In each case, the ascites were resistant to medical control and required frequent paracentesis. One patient had constant pain in keeping with mesenteric angina.

Materials and methods:

Conference: 11th Annual ENETSConcerence (2014)

Presenting Author:

Authors: Anthoney A, Patel J, Kamposioras K,

Keywords: gastroenteropancreatic neuroendocrine tumor, endoluminal stent, mesentery,

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