title: Esophageal stent fracture: case report and review of the literature.
abstract: Endoscopic esophageal stent placement is widely used in the treatment of a variety of benign and malignant esophageal conditions. Self expanding metal stents (SEMS) are associated with significantly reduced stent related mortality and morbidity compared to plastic stents for treatment of esophageal conditions; however they have known complications of stent migration, stent occlusion, tumor ingrowth, stricture formation, reflux, bleeding and perforation amongst others. A rare and infrequently reported complication of SEMS is stent fracture and subsequent migration of the broken pieces. There have only been a handful of published case reports describing this problem. In this report we describe a case of a spontaneously fractured nitinol esophageal SEMS, and review the available literature on the unusual occurrence of SEMS fracture placed for benign or malignant obstruction in the esophagus. SEMS fracture could be a potentially dangerous event and should be considered in a patient having recurrent dysphagia despite successful placement of an esophageal SEMS. It usually requires endoscopic therapy and may unfortunately require surgery for retrieval of a distally migrated fragment. Early recognition and prompt management may be able to prevent further problems.
authors.affiliation: Harshit S Khara, David L Diehl, Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, PA 17822, United States.
authors.forename: Harshit S
authors.initials: HS
authors.lastname: Khara
authors.affiliation: Harshit S Khara, David L Diehl, Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, PA 17822, United States.
authors.forename: David L
authors.initials: DL
authors.lastname: Diehl
authors.affiliation: Harshit S Khara, David L Diehl, Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, PA 17822, United States.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Gross
mesh_terms: D000368:Aged; D000497:Alloys; D003680:Deglutition Disorders / Q000209:etiology; D020878:Device Removal / Q000379:methods; D004106:Dilatation; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Esophagus; Self-expanding metal stent; Stent complication; Stent fracture; Stent migration