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Treatment of Malignant Esophageal Fistulas: Fluoroscopic Placement of Esophageal SEMS, Endoscopically-assisted through Surgical Gastrostomy. A Case Report.
- Source :
-
Journal of gastrointestinal and liver diseases : JGLD [J Gastrointestin Liver Dis] 2016 Jun; Vol. 25 (2), pp. 249-52. - Publication Year :
- 2016
-
Abstract
- Progressive esophageal carcinoma can infiltrate the surrounding tissues with subsequent development of a fistula, most commonly between the esophagus and the respiratory tract. The endoscopic placement of covered self-expanding metallic stents (SEMS) is the treatment of choice for malignant esophageal fistulas and should be performed immediately, as a fistula formation represents a potential life-threatening complication. We report the case of a 64-year-old male diagnosed with esophageal carcinoma, who had a 20Fr surgical gastrostomy tube inserted before chemo- and radiotherapy and was referred to our department for complete dysphagia, cough after swallowing and fever. The attempt to insert a SEMS using the classic endoscopic procedure failed. Then, a fully covered stent was inserted, as the 0.035" guide wire was passed through stenosis retrogradely by using an Olympus Exera II GIF-N180 (4.9 mm in diameter endoscope) via surgical gastrostomy, with a good outcome for the patient. The retrograde approach via gastrostomy under endoscopic/fluoroscopic guidance with the placement of a fully covered SEMS proved to be the technique of choice, in a patient with malignant esophageal fistula in whom other methods of treatment were not feasible.
- Subjects :
- Esophageal Fistula diagnostic imaging
Esophageal Fistula etiology
Esophageal Neoplasms pathology
Esophagoscopes
Fluoroscopy
Humans
Male
Middle Aged
Prosthesis Design
Treatment Outcome
Esophageal Fistula therapy
Esophageal Neoplasms complications
Esophagostomy instrumentation
Gastrostomy
Metals
Radiography, Interventional methods
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1842-1121
- Volume :
- 25
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of gastrointestinal and liver diseases : JGLD
- Publication Type :
- Academic Journal
- Accession number :
- 27308659
- Full Text :
- https://doi.org/10.15403/jgld.2014.1121.252.mlg