Intestinal Obstruction Due to a Migrated Esophageal Stent and Endoscopic Removal

Endoscopic esophageal stents are used with various indications, such as the treatment of benign strictures, fistulas, perforations, and esophageal cancer palliation. Stent placement is a safe and effective method. Migration is one of the most common complications of stent placement. Our case is a 61-year-old woman who presented to our clinic with weight loss and difficulty swallowing for the past 3 months. An upper gastrointestinal endoscopy was performed. A stricture was observed at the gastroesophageal junction, and a mass was found in the stomach. Biopsies later revealed gastric adenocarcinoma. Stenting was performed in a separate session. The patient’s complaints fully recovered after stenting. The patient presented to our clinic 3 months later with liquid and solid dysphagia, constipation, and abdominal pain, after receiving 3 sessions of chemotherapy. An upper gastrointestinal endoscopy was promptly performed, in which the esophageal stent was not observed in its place. Further imaging revealed that the stent had migrated to the mid ileum. The stent was removed endoscopically from the ileum, using double-balloon enteroscopy, instead of a surgical approach. We associated the displacement of the stent with tumor regression under chemotherapy, which was consistent with follow-up imaging. Follow-up visits at regular intervals, especially for patients receiving chemotherapy or radiotherapy, can prevent further complications due to migration. To prevent sliding, endoscopic clips may also be applied at the upper border of the stent. We propose double-balloon enteroscopy as an alternative method for the removal of stents from the small bowel.

Cite this article as: Kavurmacı AY, Sekuri A, Öven BB, Ergün M, Pata C. Intestinal obstruction due to a migrated esophageal stent and endoscopic removal. Diagn Interv Endosc. 2022;1(3):78-81.