Regulating migration of esophageal stents - management using a Sengstaken-Blakemore tube: A case report and review of literature

World J Gastroenterol. 2018 Jul 28;24(28):3192-3197. doi: 10.3748/wjg.v24.i28.3192.

Abstract

Stent migration, which causes issues in stent therapy for esophageal perforations, can counteract the therapeutic effects and lead to complications. Therefore, techniques to regulate stent migration are important and lead to effective stent therapy. Here, in these cases, we placed a removable fully covered self-expandable metallic stent (FSEMS) in a 52-year-old man with suture failure after surgery to treat Boerhaave syndrome, and in a 53-year-old man with a perforation in the lower esophagus due to acute esophageal necrosis. At the same time, we nasally inserted a Sengstaken-Blakemore tube (SBT), passing it through the stent lumen. By inflating a gastric balloon, the lower end of the stent was supported. When the stent migration was confirmed, the gastric balloon was lifted slightly toward the oral side to correct the stent migration. In this manner, the therapy was completed for these two patients. Using a FSEMS and SBT is a therapeutic method for correcting stent migration and regulating the complete migration of the stent into the stomach without the patient undergoing endoscopic rearrangement of the stent. It was effective for positioning a stent crossing the esophagogastric junction.

Keywords: Boerhaave syndrome; Endoscopy; Enteral nutrition; Esophageal perforation; Self-expandable metallic stents.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anastomotic Leak / therapy*
  • Drainage
  • Esophageal Perforation / prevention & control
  • Esophageal Perforation / surgery*
  • Esophagoscopy / instrumentation
  • Esophagoscopy / methods
  • Esophagus / surgery*
  • Gastric Balloon / statistics & numerical data*
  • Humans
  • Male
  • Mediastinal Diseases / surgery*
  • Middle Aged
  • Self Expandable Metallic Stents / adverse effects*
  • Treatment Outcome

Supplementary concepts

  • Boerhaave syndrome