Duodenal perforation due to a migrated metallic self-expanding oesophageal stent

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• 作者：Muthukumaran Rangarajan (1)
  Chinnusamy Palanivelu (1)
  Kribha Shankar (1)
  Priyadarshan Anand (1)
  Natesan Vijay Anand (1)
  
• 关键词：Oesophageal stenting ; Palliation ; Duodenal perforation ; Fistula
• 刊名：Hellenic Journal of Surgery
• 出版年：2012
• 出版时间：November 2012
• 年：2012
• 卷：84
• 期：6
• 页码：390-393
• 全文大小：318KB
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• 作者单位：Muthukumaran Rangarajan (1)
  Chinnusamy Palanivelu (1)
  Kribha Shankar (1)
  Priyadarshan Anand (1)
  Natesan Vijay Anand (1)
  
  1. GEM Hospital & Postgraduate Institute, Pankaja, India
  

文摘

Aim-Background Duodenal perforation associated with a self-expandable esophageal metallic stent is very rare. We present a case of duodenal perforation due to a self-expandable metallic stent placed to palliate dysphagia in an elderly male patient with inoperable adenocarcinoma of the gastroesophageal junction. Case Report This patient presented ten days later with acute abdomen due to perforative peritonitis. Emergency laparotomy revealed bile in the peritoneal cavity and a large duodenal perforation, with the stent protruding through it. Postoperatively, the patient developed a leak in the suture line and despite our best efforts, succumbed on the 25th postoperative day. Discussion Stent migration occurs in 0-5% of patients and occurs more frequently when the stent is positioned across the gastroesophageal junction. Migration can be prevented by cleverly designing these stents and using improved techniques of deployment as experience increases. A strong suspicion of perforation has to be borne in mind when a patient develops acute abdomen following stenting. Surgery is the ideal treatment for all perforations due to stent migrations, even though it carries a high mortality rate.