Mediastinal migration of self-expanding bronchial stents in the management of malignant bronchoesophageal fistula.
Airway stents are commonly used to palliate malignant central airway obstruction and tracheo-/bronchoesophageal fistulas. Despite their efficacy in immediately relieving airway obstruction, they can be associated with a variety of complications. We report the case of a 44-year-old woman with a malignant bronchoesophageal fistula treated initially with a self-expanding silicone mesh stent in the left main bronchus followed 2 weeks later by an esophageal stent. Shortly afterward, she presented with chest pain, worsening cough, and breathlessness. A CT scan of the chest revealed the airway stent in the contralateral mediastinum perforating the right main bronchus. We discuss her subsequent management and complications associated with self-expanding airway stents in this setting.
Department of Interventional Pulmonary Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Saleh
S
Alazemi
Respiratory Medicine Directorate (Eastern Deanery), Ida Darwin Site, Fulborn, Cambridge, UK.
Sumit
S
Chatterji
Department of Interventional Pulmonary Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Armin
A
Ernst
Department of Interventional Pulmonary Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
David
D
Berkowitz
Department of Interventional Pulmonary Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Gaetane
G
Michaud
Department of Interventional Pulmonary Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: amajid@bidmc.harvard.edu.
Adnan
A
Majid
D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy*; D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D001983:Bronchial Fistula / Q000209:etiology / Q000628:therapy*; D004937:Esophageal Fistula / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications*; D006801:Humans; D008479:Mediastinal Neoplasms / Q000150:complications / Q000556:secondary; D008482:Mediastinum; D011474:Prosthesis Design; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed