Case Report
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World J Gastroenterol. Mar 14, 2014; 20(10): 2715-2720
Published online Mar 14, 2014. doi: 10.3748/wjg.v20.i10.2715
Esophageal stent fracture: Case report and review of the literature
Harshit S Khara, David L Diehl, Seth A Gross
Harshit S Khara, David L Diehl, Department of Gastroenterology and Nutrition, Geisinger Medical Center, Danville, PA 17822, United States
Seth A Gross, Division of Gastroenterology, NYU School of Medicine, NYU Langone Medical Center, New York, NY 10028, United States
Author contributions: Khara HS, Diehl DL and Gross SA all contributed equally to this work; Khara HS and Gross SA were involved in the clinical management of the case, while all three authors were equally involved in the preparation of the manuscript.
Correspondence to: Harshit S Khara, MD, Department of Gastroenterology and Nutrition, Geisinger Medical Center, 100 N. Academy Ave, 21-11, Danville, PA 17822, United States. harshitkhara@hotmail.com
Telephone: +1-570-2716856 Fax: +1-570-2716852
Received: August 26, 2013
Revised: September 13, 2013
Accepted: September 29, 2013
Published online: March 14, 2014
Processing time: 198 Days and 4.4 Hours
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.

Keywords: Esophagus; Self-expanding metal stent; Stent complication; Stent fracture; Stent migration

Core tip: Esophageal self expanding metal stents are widely used for the treatment of a variety of benign and malignant esophageal conditions. A rare and infrequently reported complication of this procedure is stent fracture and subsequent migration of the broken pieces. There have only been a handful of case reports describing this problem. We report a case of spontaneous fracture of a nitinol esophageal self expanding metal stent, the first reported case from the United States, and review the available literature on this unusual occurrence.