Display options
Share it on

Int J Surg Case Rep. 2015;11:113-116. doi: 10.1016/j.ijscr.2015.04.030. Epub 2015 Apr 29.

Small bowel perforation due to a migrated esophageal stent: Report of a rare case and review of the literature.

International journal of surgery case reports

Servet Karagul, Mehmet Ali Yagci, Cengiz Ara, Ali Tardu, Ismail Ertugrul, Serdar Kirmizi, Fatih Sumer

Affiliations

  1. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: [email protected].
  2. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: [email protected].
  3. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: [email protected].
  4. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: [email protected].
  5. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: [email protected].
  6. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: [email protected].
  7. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey. Electronic address: [email protected].

PMID: 25967554 PMCID: PMC4446686 DOI: 10.1016/j.ijscr.2015.04.030

Abstract

INTRODUCTION: Endoscopic esophageal stent placement is used to treat benign strictures, esophageal perforations, fistulas and for palliative therapy of esophageal cancer. Although stent placement is safe and effective method, complications are increasing the morbidity and mortality rate. We aimed to present a patient with small bowel perforation as a consequence of migrated esophageal stent.

PRESENTATION OF CASE: A 77-years-old woman was admitted with complaints of abdominal pain, abdominal distension, and vomiting for two days. Her past medical history included a pancreaticoduodenectomy for pancreatic tumor 11 years ago, a partial esophagectomy for distal esophageal cancer 6 months ago and an esophageal stent placement for esophageal anastomotic stricture 2 months ago. On abdominal examination, there was generalized tenderness with rebound. Computed tomography showed the stent had migrated. Laparotomy revealed a perforation localized in the ileum due to the migrated esophageal stent. About 5cm perforated part of gut resected and anastomosis was done. The patient was exitus fifty-five days after operation due to sepsis.

DISCUSSION: Small bowel perforation is a rare but serious complication of esophageal stent migration. Resection of the esophagogastric junction facilitates the migration of the stent. The lumen of stent is often allow to the passage in the gut, so it is troublesome to find out the dislocation in an early period to avoid undesired results. In our case, resection of the esophagogastric junction was facilitated the migration of the stent and late onset of the symptoms delayed the diagnosis.

CONCLUSION: Patients with esophageal stent have to follow up frequently to preclude delayed complications. Additional technical procedures are needed for the prevention of stent migration.

Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Endoscopic intervention; Esophagectomy; Esophagus cancer; Migration; Stent

References

  1. Endoscopy. 2011;43 Suppl 2 UCTN:E145-6 - PubMed
  2. BMC Gastroenterol. 2012 Feb 29;12:19 - PubMed
  3. World J Gastrointest Endosc. 2014 Feb 16;6(2):49-54 - PubMed
  4. Surg Endosc. 1997 Apr;11(4):383-4 - PubMed
  5. Dis Esophagus. 2013 Feb-Mar;26(2):154-8 - PubMed
  6. Am Surg. 2000 Oct;66(10):956-8; discussion 958-9 - PubMed
  7. Ugeskr Laeger. 2010 Aug 16;172(33):2234-5 - PubMed
  8. World J Gastrointest Surg. 2014 Mar 27;6(3):38-41 - PubMed
  9. Am J Gastroenterol. 2010 Feb;105(2):258-73; quiz 274 - PubMed
  10. Gastrointest Endosc. 2005 Sep;62(3):474-5 - PubMed
  11. Case Rep Gastroenterol. 2009 Apr 15;3(1):61-66 - PubMed
  12. J Vasc Interv Radiol. 2000 Jul-Aug;11(7):902-4 - PubMed
  13. Dis Esophagus. 2009;22(4):331-6 - PubMed
  14. Dis Esophagus. 2010 Sep;23(7):590-6 - PubMed
  15. Dis Esophagus. 2009;22(6):519-25 - PubMed

Publication Types