Colonic Stent Perforation Risk — SCE Palliative Medicine MCQ

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ModerateGI SymptomsColonic Stent Perforation RiskSCE Palliative Medicine

A 72‑year‑old man with advanced colorectal cancer develops acute large bowel obstruction from a sigmoid tumour. He is not a surgical candidate. An endoscopic colonic stent is placed for decompression. What is the most important early complication to monitor for?

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Correct answer: A — Perforation — the most serious early complication of colonic stenting, with a 3–10 % risk

The correct answer is A. Perforation is the most critical early complication of colonic self-expandable metal stents (SEMS). A meta-analysis of 4,086 patients found a perforation rate of 7.4%, establishing it as a notable risk early after placement. Additionally, systematic reviews list perforation among the principal early adverse outcomes, alongside pain and bleeding, whereas migration typically occurs later. The other options—autoimmune reaction, allergic response, stent dissolution—are either not recognized complications or physiologically implausible; migration, although possible, is predominantly a late complication and less immediately life‑threatening.

Reference: Perforation in colorectal stenting: a meta-analysis and a search for risk factors. 2014; and Colonic stent‑related complications and their management. 2014. https://pubmed.ncbi.nlm.nih.gov/24650852/