Treatment of Proximal Esophagobronchial Fistula with an Anti-migration Esophageal Stent |
So Yoon Yoon, Ki Nam Shim, Sun Kyung Na, Jae In Ryu, Hye Won Yun, Seong Eun Kim, Hye Kyung Jung, Sung Ae Jung |
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. shimkn@ewha.ac.kr |
이동방지 식도 스텐트를 이용한 상부 식도기관지누공의 치료 1예 |
윤소윤, 심기남, 나선경, 류재인, 윤혜원, 김성은, 정혜경, 정성애 |
이화여자대학교 의학전문대학원 내과학교실 |
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Abstract |
An esophagobronchial fistula is a life threatening complication of esophageal carcinoma. Although placement of esophageal stents is the preferred treatment for esophagobronchical fistula, experience of stenting at the proximal esophagus is limited due to technical difficulties, patients' discomfort and high risk of complications. We report here a patient with an esophagobronchial fistula at the proximal esophagus who was successfully treated by insertion of a self expandable metal stent and earlobe fixation by a connective tube for preventing stent migration. A 46-year-old man had an inoperable esophageal carcinoma and lung abscess due to esophagobronchial fistula. Our first placement of stent at the proximal esophagus failed because of foreign-body sensations and stent migration to the proximal region. For the second time, treatment adding an earlobe fixation tool for anti-migration to the esophageal stent was successful with no serious procedure-related complications. The stent completely sealed off the fistula in the patient without further aspiration and serious discomfort symptoms. Lung abscess and pneumonia gradually improved. Anti-migration esophageal stents can be effective in preventing stent migration for the treatment of proximal esophagobronchial fistula due to malignancy. |
Key Words:
Esophageal fistula; Stents |
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