title: Large tracheobronchial fistula due to esophageal stent migration: Let it be!
abstract: We report tracheal-bronchial migration of a covered esophageal self-expanding metal stent used to relieve dysphagia in a patient with advanced esophageal cancer. The stent eroded the trachea and completely occluded the main left bronchus. Surgery was contraindicated due to her poor clinical condition, and insertion of another stent in the trachea, esophagus, or both was contraindicated due to extension of the fistula. Esophageal exclusion with a combination of cervical esophagostomy and an enteral feeding tube was the only feasible treatment to minimize spoilage by aspirated saliva and provide enteral nutrition.
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy alfonso.fiorelli@unina2.it.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Fiorelli
authors.affiliation: General Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Esposito
authors.affiliation: Pneumology Unit, Pollena Trocchia Hospital, Pollena Trocchia, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Pedicelli
authors.affiliation: Radiology Unit, Second University of Naples, Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reginelli
authors.affiliation: Gastrointestinal Endoscopy Unit, Second University of Naples, Naples, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Esposito
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Santini
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001999:Bronchoscopy; D003679:Deglutition; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016145:Endoscopy, Digestive System; D004750:Enteral Nutrition / Q000295:instrumentation; D004938:Esophageal Neoplasms / Q000150:complications* / Q000473:pathology; D004946:Esophagostomy; D004947:Esophagus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014133:Tracheal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
keywords: Esophageal neoplasms; esophageal stenosis; esophagus; stents; tracheoesophageal fistula