Endoscopic Treatment of Stent-Related Esophagobronchial Fistula

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