Endoscopy 1997; 29(5): 416-420
DOI: 10.1055/s-2007-1004227
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Massive Hemorrhage Caused by a Perforating Gianturco-Z Stent Resulting in an Aortoesophageal Fistula

P. D. Siersema1 , T. G. Tan2 , F. F. J. M. Sutorius3 , J. Dees1 , M. van Blankenstein1
  • 1Dept. of Internal Medicine, Division of Gastroenterology, University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands
  • 2Dept. of Internal Medicine, Streekziekenhuis, Hengelo, The Netherlands
  • 3Dept. of Pathology, East Netherlands Pathology Laboratory, Enschede, The Netherlands
Further Information

Publication History

Publication Date:
17 March 2008 (online)

Abstract

Endoscopic placement of self-expanding metal stents is regarded as a safe and effective method of palliating obstructive esophageal malignancies. We report here the case of a 49-year-old woman with an inoperable squamous-cell carcinoma located in the mid-esophagus. After two courses of chemotherapy, a silicone-covered Gianturco-Z stent was placed because of progressive tumor growth. Eighteen days after the stent placement, the patient presented with hematemesis, and died 24 hours after admission. At autopsy, the proximal end of the stent was found to have perforated through the normal esophageal mucosa into the aorta, resulting in an aortoesophageal fistula. This complication should be considered in patients who present with massive hemorrhage after undergoing radiotherapy or chemotherapy, or both, before stent placement in the mid-esophagus.