Occlusion of a Large Esophagotracheal Fistula by Double Stents after Extubation of an Esophageal Stent that Completely Perforated the Trachea

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  • 食道ステント気管内完全穿孔による巨大食道気管瘻をダブルステントで閉鎖した 1 例

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A large defect in the esophagotracheal wall was caused by complete perforation of an esophageal stent into the trachea in a 67-year-old man with esophageal cancer in whom esophagotracheal fistula appeared after chemoradiotherapy. An esophageal stent had been placed to seal the fistula 3 months previously. The patient visited our department with severe symptoms of sputa, cough, dyspnea, high fever and dysphagia. Bronchoscopic examination showed the complete perforation of the esophageal stent into the trachea. After extubation of the perforated stent using a rigid bronchoscope, the wall defected was 8.0 cm in length. Double stent insertion was then performed, using a Dynamic stent for the trachea and a covered Ultraflex for the esophagus. After the double stenting, the patient was capable of semi-solid food intake, and his aspiration pneumonia improved. Double stenting is an useful modality for occlusion of esophagotracheal large fistulas and can improve the quality of life of the patient.

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