UPPER GI ENDOSCOPY

(Therapeutic)

Complications of esophageal stenting. An overview

The complication rate depends on the use of:

plastic
metallic self-expandable stents

and the location of the stricture:

proximal
distal

The combined risk of complications (early and late) ranges from 22 to 31 %

Early complications of esophageal stenting.

Perforation

It occurs in 8 to 10 % in large series as a complication of the dislodgement of plastic stents and in 3 % in the use of metallic self-expandable stents.

* Perforation by balloon dilation :

Perforation by balloon dilation.

After the setting of an esophageal prosthesis, the fistula is occluded and the patient could ingest food orally

Perforation by balloon dilation.

After the setting of an esophageal prosthesis, the fistula is occluded and the patient could ingest food orally

Perforation by balloon dilation.

After the setting of an esophageal prosthesis, the fistula is occluded and the patient could ingest food orally

Stent migration

In large series it occurs in 22 % as a complication of the dislodgement of plastic stents and in 12,5 % in the use of metallic self-expandable stents.

* Spontaneous plastic stent migration :

Spontaneous plastic stent migration.

First Xray examination :

the prosthesis in correct position,...

Second Xray examination :

The prosthesis is located now below the tumor.

Bleeding

Late complications of esophageal stenting.

Stent dislodgement

Obstruction

- tumor in/overgrowth : It occurs in 6.25 % of cases in the use of metallic self-expandable stents.

- food impaction : It occurs in large series as a complication of :

* plastic stenting	10-20 %
* metallic stenting	6-35 %
(as a combination of food impaction and tumor in/overgrowth)

(food impact)

Food impact due to a large piece of ingested meal .

Removal by foreign body forceps

Severe esophagitis