Document Detail


Esophageal perforation due to removal of partially covered self-expanding metal stents placed for a benign perforation or leak.
MedLine Citation:
PMID:  21165825     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Benign esophageal perforations and anastomotic leaks can be effectively managed by stent placement. However, when partially covered self-expanding metal stents (SEMS) are used, safe removal may be complicated. In this case series, we evaluated the complicated removal of SEMS placed for a benign esophageal perforation or leak in four patients. In all patients a partially covered SEMS was placed. After a median stent time of 29 days (range 21 - 30), the SEMS were found to have become embedded in the esophageal wall. Endoscopic removal resulted in perforation in all patients. All patients recovered uneventfully, although one patient underwent esophagectomy. If uncovered SEMS ends become embedded, removal of the stent may cause major damage to the esophageal wall. It is therefore recommended to remove embedded partially covered SEMS only after first placing a fully covered SEMS or self-expanding plastic stent inside this stent to necrotize the ingrown tissue at the uncovered stent ends.
Authors:
M M Hirdes; F P Vleggaar; K Van der Linde; M Willems; E R Totté; P D Siersema
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Publication Detail:
Type:  Journal Article     Date:  2010-12-16
Journal Detail:
Title:  Endoscopy     Volume:  43     ISSN:  1438-8812     ISO Abbreviation:  Endoscopy     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  156-9     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Affiliation:
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands.
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