title: Remember to crush the tablets after esophageal stent insertion.
abstract: The main mode of palliation for inoperable esophageal cancer is by insertion of expandable metallic stents. While major complications include occlusion by tumor ingrowth and migration, impaction by food has been reported in as many as 10% of cases. Although patients are routinely instructed to follow a soft and finely minced diet after insertion of esophageal stents, stent blockage can still occur if patients swallow large-sized tablets. We report a case of stent blockage by 2 large-sized tablets, about which the endoscopist did not forewarn the patient or his family. The tablets were eventually dislodged easily through a repeat endoscopy. We caution about the possibility of such complication after esophageal stenting. We recommend inspection of patients' medication before the stenting procedure as well as instructing patients, their family, and care providers to crush their large-sized tablets before consumption.
authors.affiliation: Division of Gastroenterology, Department of Medicine, National University Hospital, Singapore 119074. waict@nuh.com.sg
authors.forename: Chun-Tao
authors.initials: CT
authors.lastname: Wai
authors.forename: Dede Selamat
authors.initials: DS
authors.lastname: Sutedja
authors.forename: Yin-Mei
authors.initials: YM
authors.lastname: Lee
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology / Q000628:therapy; D003680:Deglutition Disorders / Q000517:prevention & control*; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy; D004940:Esophageal Stenosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D019919:Prosthesis Implantation / Q000295:instrumentation*; D015607:Stents; D013607:Tablets / Q000008:administration & dosage*
chemical_list: D013607:Tablets