A 74-year-old man with a previous history of surgery for
pharyngolaryngeal neoplasia and reconstruction in 2006 with muscle graft was
referred to our unit for dysphagia. Upper endoscopy showed a narrow stricture
at the muscle graft-esophageal anastomosis that was 20 mm long. The
patient underwent five sessions of esophageal dilation with the CRE Balloon
Dilator (Boston Scientific, Natick, Massachusetts, USA) with early relapse and
weight loss.
Therapeutic options were discussed with the patient, and we decided
to place an 80-mm SX-ELLA Esophageal Degradable BD stent (ELLA-CS, Hradec
Králové, Czech Republic). It was placed under fluoroscopic
guidance without complications. The patient presented an initial improvement
from dysphagia grade 4 to dysphagia grade 2, but after 9 weeks he attended the
emergency ward for aphagia.
An urgent upper endoscopy was performed showing a collapse of the
biodegradable stent mesh inside the esophageal lumen ([Fig. 1]); the collapsed mesh did not allow the
passage of a standard Pentax endoscope. A foreign body forceps was used to
remove the filaments of partially reabsorbed polydioxanone mesh until a clear
lumen was obtained that allowed easy passage of the endoscope ([Fig. 2]). The patient was discharged from hospital
the next day with an improvement of his dysphagia.
Fig. 1 a – c Biodegradable
stent mesh collapsed inside the esophageal lumen.
Fig. 2 Esophageal lumen after
removing the stent mesh with foreign body forceps.
Endoscopy_UCTN_Code_CPL_1AH_2AD
