Abstract:
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 5 cm 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.