Self-expandable metal stent migration – an unexpected location

We report the case of a 75-year-old male with a history of gastroesophageal junction adenocarcinoma submitted to neoadjuvant chemoradiotherapy and subtotal esophagectomy. Two months after the surgery, the patient developed dysphagia due to anastomotic stricture (with no evidence of tumour recurrence). Serial endoscopic balloon dilations were unsuccessful. A fully covered self-expandable metal stent (SEMS) was placed, but the patient missed follow-up endoscopies. One year later, the patient presents to the emergency department with a 10-day history of abdominal pain. An abdominal CT scan revealed the previously inserted metal sent was lodged in the hepatic angle of the colon, and excluded further complications. Intravenous antibiotics were initiated and a colonoscopy was performed, with successful retrieval of the metal stent using careful traction with a foreign body forceps.

Metal stents are a valid therapeutic option for oesophageal strictures. Its use is usually restricted to patients who fail previous endoscopic dilation therapy, given its relatively high rate of adverse events. Stent migration, for instance, can occur in up to 32% of patients, being the most common stent-related complication. Most migrated stents are not responsible for complications, usually remaining in the stomach or even exiting the body spontaneously, while others might cause obstruction. Given its wider lumen, the colon is not a common site of stent impaction. This case illustrates a colonic impaction that was amenable to endoscopic retrieval, without further complications [1] [2] [3] [4].

Publication History

Article published online:
27 March 2025

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