Endoscopic Treatment of Stent-Related Esophagobronchial Fistula

A 64-year-old man suffering from progressive dysphagia due to malignant esophageal stenosis was admitted for the onset of cough that worsened after meals and shortness of breath. The patient had been treated 2 weeks before with the placement of a partially covered self-expandable metal stent in the upper-mid esophagus (Niti-S Doubletype, 22x80 mm, Taewoong Medical, Seoul, South Korea). A chest x-ray showed no abnormalities, but a subsequent upper gastrointestinal tract x-ray with contrast showed the passage of gastrografin (Bayer, Germany) within the mainstream left bronchus, starting from the lower end of the esophageal stent (Figure 1). An upper endoscopy confirmed the suspicion, showing a small orifice in the esophageal wall, closer to the lower end of metallic stent (Figure 2).