PMC5291716_01
CT scan showing a markedly distended stomach and near total obstruction of the pylorus.
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F1
A computed tomography (CT) scan of the abdomen showed a markedly distended stomach, with a soft tissue focus at the gastric outlet resulting in near total obstruction of the pylorus (Figure 1).
(A) LAMS being deployed into the stenotic pyloric channel via a through-the-scope technique. (B) View through the patent LAMS at 3 weeks post stent placement, showing healing pyloric channel and non-migration.
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F2
The dumbbell-shaped LAMS was endoscopically placed across the pyloric channel (Figure 2). Abdominal X-ray and repeat EGD demonstrated appropriate placement of the stent in the pylorus with a patent lumen and resolution of severe ulcerative disease (Figure 2).
PMC5291716_02
CT scan showing a distended stomach, severely narrowed anastomosis (arrow), and a small amount of fluid entering the decompressed jejunum.
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F3
CT scan showed a markedly distended stomach with a narrow gastrojejunal anastomosis causing GOO (Figure 3).
(A) Initial EGD demonstrating the severely stenotic gastrojejunal anastomosis (circle). (B) Follow-up EGD at 3 months showing that the LAMS remained in place and fully patent.
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F4
EGD revealed LA grade D esophagitis, erythematous gastric mucosa with an ulcer in the body, which was clipped due to bleeding on contact, and a severely stenotic gastrojejunal anastomosis (Figure 4). At 3 months post placement, endoscopy showed appropriate stent location and patent lumen (Figure 4).