case_images: PMC11815688_01
case_images: Initial coronal (A) and axial (B) computed tomography (CT) scan of the abdomen, with a tumor arising from the ascending colon (*), with local invasion of the right kidney (white arrowhead) and a malignant duodenocolic fistula (thick white arrow), connecting the ascending colon with the duodenal tract (x).
case_images: gr1.jpg
case_images: PMC11815688_01_gr1.jpg
case_images: f0005
case_images: The CT-scan showed a locally invasive tumor in the ascending colon with a fistula connecting the large intestine with the duodenal tract (Fig. 1).
case_images: A: Intraoperative X-ray during stent placement by gastroscopy, securing correct insertion and placement of the Niti-S fully covered duodenal stent (black arrowhead) in relation to the fistula. B: X-ray after the procedure was finished, demonstrating the attachment of the stent, secured by two OTSC clips (thin black arrow) in the proximal end of the stent.
case_images: gr2.jpg
case_images: PMC11815688_01_gr2.jpg
case_images: f0010
case_images: Treitz ligament, followed by continuous retraction past the 3 cm wide opening of the fistula, thereby fully covering the perforation, with the proximal end of the stent located in the pylorus. The stent was secured by two OTSC clips (Ovesco Endoscopy AG, Germany) in the oral end (Fig. 2).
case_images: A: Conventional X-ray in anterior-posterior (AP) projection. B: Computed tomography (CT) scan of the abdomen. Diagnostic imaging performed three weeks after the endoscopic placement of a fully covered duodenal stent. The stent is correctly positioned (black arrowhead), and still fixated orally by the two OTSC slips (thin black arrow), hereby covering the opening of the malignant fistula (thick white arrow) created by the ascending colon tumor (*).
case_images: gr3.jpg
case_images: PMC11815688_01_gr3.jpg
case_images: f0015
case_images: Here, the stent was found to be correctly positioned (Fig. 3).