Endoscopy 2011; 43(2): 156-159
DOI: 10.1055/s-0030-1255849
Case Report/series

© Georg Thieme Verlag KG Stuttgart · New York

Esophageal perforation due to removal of partially covered self-expanding metal stents placed for a benign perforation or leak

M.  M.  C.  Hirdes1 , F.  P.  Vleggaar1 , K.  Van der Linde2 , M.  Willems1 , E.  R.  Totté3 , P.  D.  Siersema1
  • 1Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands
  • 2Department of Gastroenterology, Medical Center Leeuwarden, The Netherlands
  • 3Department of Surgery, Medical Center Leeuwarden, The Netherlands
Further Information

Publication History

submitted 12 May 2010

accepted after revision 25 August 2010

Publication Date:
16 December 2010 (online)

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.

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M. M. C. HirdesMD 

Department of Gastroenterology and Hepatology
University Medical Center Utrecht

Heidelberglaan 100
3584 CX Utrecht
The Netherlands

Fax: +31-88-7555533

Email: M.M.C.Hirdes@umcutrecht.nl

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