Endoscopic management of corrosive esophageal stenosis by temporary stent placement

Introduction. Ingestion of corrosive substances often causes serious damage to the upper gastrointestinal mucosa, occasionally perforation and, in rare cases, death. Most of these events are accidental, especially in children and the elderly, and voluntary (for suicidal purposes) in adults. If the patient survives the acute episode, the long-term complications are mainly esophageal and/or gastric stenosis and esophageal cancer after 1-2 decades of evolution. Endoscopic treatment of benign esophageal stenosis consists of dilation with Savary bougies and dilation balloon, esophageal stent assembly, with the purpose of restoring esophageal luminal patency. Superior digestive endoscopy plays an important role in the evaluation of benign esophageal stenosis in terms of the severity and the extent of stenosis. Case presentation. We present the case of a 47-yearold patient admitted to our clinic for dysphagia for solid and semi-solid foods. Endoscopy revealed an esophageal stricture due to the voluntary ingestion of caustic substance with suicidal purpose, 9 months before presentation. After multiple sessions of endoscopic dilatation with Savary bougies, an esophageal stent was placed, that solved patient’s dysphagia. Conclusions. Post-caustic esophageal stenosis is a common cause of dysphagia in patients with ingestion of corrosive substances. Patients can benefit from endoscopic esophageal stent placement treatment

The Use of Esophageal Stents in the Management of Postoperative Fistulas—Current Status, Clinical Outcomes and Perspectives—Review

Esophageal fistula remains one of the main postoperative complications, with the treatment often requiring the use of stents. This article reviews the updates on the use of endoscopic stents for the treatment of postoperative esophageal leakage in terms of indications, types of stents used, efficiency, specific complications and perspectives. Materials and Methods: We searched the PubMed and MEDLINE databases for the keywords postoperative esophageal anastomotic leak and postoperative esophageal anastomotic leak stent, and retrieved relevant papers published until December 2022. Results: The endoscopic discovery of the fistula is usually followed by the insertion of a fully covered esophageal stent. It has an efficiency of more than 60% in closing the fistula, and the failure is related to the delayed application of the method, a situation more suitable for endo vac therapy. The most common complication is migration, but life-threatening complications have also been described. The combination of the advantages of endoscopic stents and vacuum therapy is probably found in the emerging VACstent procedure. Conclusions: Although the competing approaches give promising results, this method has a well-defined place in the treatment of esophageal fistulas, and it is probably necessary to refine the indications for each individual procedure