Covered metallic stent treatment of a patient with spontaneous rupture of the esophagus

Abstract

A patient with a potentially fatal condition as a result of esophago-pneumo-broncho fistula was successfully treated with the insertion of a self-expanded covered metallic stent. Severe regurgitation resulted in the removal of the stent 3 months after insertion. Stricture after removal of the stent required pneumatic balloon dilation. The use of a self-expanded covered metallic stent is effective for the treatment of spontaneous esophageal rupture; however, early removal of the stent is recommended.

Closure of Benign Leaks, Perforations, and Fistulas With Temporary Placement of Fully Covered Metal Stents

“…29 Covered metallic stents have been successfully used to alleviate patients with malignant perforation 30 and fistula, 31 and are also reported to have been useful in individual cases of Boerhaave syndrome. [32][33][34][35][36][37][38] In our series, primary closure of the fistulous opening was achieved in 79% of patients. This result is similar to that of other series of PC-SEMS or FC-SEMS placements.…”

Oesophageal stenting

“…However, controversy remains about the best management [149]. The results of several case series have been published, advocating endoluminal stenting in the management of Boerhaave's syndrome as well as for other causes of benign perforation [150][151][152][153][154][155][156][157][158][159].…”

Omental wrapping of esophageal rupture in combination with T-tube drainage

“…A number of treatment methods have been reported, including conservative treatments [3,21,22], metallic stent [23][24][25], esophagostomy [14], controlled fistula by T-tube [5][6][7], vascularized pedicle tissue flap using omentum [8], fundoplasty [10,11], primary closure [2,3], and esophagectomy [4]. The T-tube method was first reported by Abbott et al in 1970 [20].…”