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].
