Abstract
Esophageal stent placement is used to treat benign strictures, esophageal perforations, fistulas and for palliative therapy of esophageal cancer. Although it is a safe and effective method, complications are increasing the morbidity and mortality rate. Small bowel perforation as a result of esophageal stent migration is a remarkably rare occurrence. We report one case from our clinical experience and undertake a review of the previously reported cases retrieved from the PubMed. A total of six cases were found accessible. Abdominal pain was the common clinical presentation. The mean time from stent placement to perforation was 3.4 months (range, two weeks to 12 months). The jejunum was the frequently perforated portion of the small bowel. Surgical intervention was the mainstay of treatment. This comparative review illustrates that clinicians should remain vigilant for small bowel perforation in patients with esophageal stent placement. Further studies are required to delineate the magnitude and scope of this association.
Highlights
Endoscopic stent placement has frequently been used to maintain the esophageal luminal patency in patients with strictures, esophageal perforations, fistulas, and for palliative treatment of esophageal cancer [1, 2]
Various immediate and delayed complications associated with this procedure are relatively increasing the morbidity and mortality rate
We chronicle the case of a patient where esophageal self-expanding metallic stent migration culminated in a jejunal perforation
Summary
Endoscopic stent placement has frequently been used to maintain the esophageal luminal patency in patients with strictures, esophageal perforations, fistulas, and for palliative treatment of esophageal cancer [1, 2]. Small bowel perforation as a result of esophageal stent migration is a rare but high-risk clinicopathologic entity with only a handful of cases reported far [5]. The pain was diffuse, sharp, and it was concentrated in the lower abdomen Her past medical history was significant for breast carcinoma status post bilateral mastectomy, hysterectomy, Helicobacter pylori infection successfully treated with triple therapy and metastatic squamous cell carcinoma of the esophagus. Four years ago, she underwent an uneventful placement of a fully covered 19 x 100-mm esophageal Wallflex® stent (Boston Scientific, Natick, MA, USA). On the one-month follow-up, she reported a good recovery without any inadvertent events or recurrence of the gastrointestinal complaints
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