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Surgical Endoscopy
Published in: Surgical Endoscopy 4/2015

01-04-2015 | Dynamic Manuscript

Iatrogenic pharyngoesophageal perforations treated with fully covered self-expandable metallic stents (with video)

Authors: Vivek Kumbhari, Alba A. Azola, Alan H. Tieu, Reetika Sachdeva, Payal Saxena, Ahmed A. Messallam, Mohamad H. El Zein, Patrick I. Okolo III, Mouen A. Khashab

Published in: Surgical Endoscopy | Issue 4/2015

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Abstract

Background

Iatrogenic pharyngoesophageal perforations are a rare but serious complication of endoscopy. Surgical and non-surgical approaches have been reported but result in a significant morbidity and extended hospital stay. Therefore, an unmet need exists for an alternative management technique. We demonstrate a new endoscopic approach for the management of iatrogenic pharyngoesophageal perforations through the use of esophageal fully covered self-expandable metallic stents (FCSEMS).

Patients and methods

Two patients who underwent flexible endoscopy each suffered a large iatrogenic perforation detected intraprocedurally. After emergency intubation, an esophageal FCSEMS was deployed in the hypopharynx and the patient admitted to the intensive care unit. On day 3, the patients underwent an esophagogastroduodenoscopy with stent removal.

Results

There was complete closure of the perforations on day 3. The patients were extubated and subsequently tolerated a soft diet. The patients were discharged home on day 4.

Conclusions

The placement of a removable FCSEMS in the setting of an acutely diagnosed perforation may be a suitable minimally invasive approach for the management of iatrogenic pharyngoesophageal perforations.
Appendix
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Metadata
Title
Iatrogenic pharyngoesophageal perforations treated with fully covered self-expandable metallic stents (with video)
Authors
Vivek Kumbhari
Alba A. Azola
Alan H. Tieu
Reetika Sachdeva
Payal Saxena
Ahmed A. Messallam
Mohamad H. El Zein
Patrick I. Okolo III
Mouen A. Khashab
Publication date
01-04-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 4/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3767-4

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