Stent migration to the ileum: a potentially lethal complication after Montgomery salivary bypass tube placement for hypopharyngeal stenosis after laryngectomy.
BACKGROUND
Montgomery salivary bypass tubes (MSBTs) have been used for decades in the treatment of stenoses and fistulae of the hypopharynx and the cervical esophagus. Generally, MSBT use is not associated with serious complications. Only a small number of cases with severe MSBT-associated complications have been reported in the literature.


RESULTS
We report for the first time an MSBT migration to the ileum in a laryngectomized patient who underwent surgical pharyngocutaneous fistula closure with MSBT placement. The MSBT was removed surgically via laparotomy. The patient died 15 days later due to sepsis associated with peritonitis.


CONCLUSIONS
To avoid potentially lethal complications associated with MSBT migration into the intestinal tract, we recommend secure fixation of the MSBT to a nasogastric tube.
Bitter
Thomas
T
Department of Otorhinolaryngology, Friedrich-Schiller University, Jena, Germany. Thomas.Bitter@med.uni-jena.de
Pantel
Mira
M
Dittmar
Yves
Y
Guntinas-Lichius
Orlando
O
Wittekindt
Claus
C
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003251:Constriction, Pathologic; D005548:Foreign-Body Migration; D006801:Humans; D007013:Hypopharynx / Q000473:pathology* / Q000601:surgery; D007082:Ileum; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D010608:Pharyngeal Diseases / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D015607:Stents / Q000009:adverse effects*