Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2018; 24(28): 3192-3197
Published online Jul 28, 2018. doi: 10.3748/wjg.v24.i28.3192
Regulating migration of esophageal stents - management using a Sengstaken-Blakemore tube: A case report and review of literature
Hisaho Sato, Kaoru Ishida, Shusaku Sasaki, Masahiro Kojika, Shigeatsu Endo, Yoshihiro Inoue, Akira Sasaki
Hisaho Sato, Masahiro Kojika, Shigeatsu Endo, Yoshihiro Inoue, Department of Critical Care Medicine, Iwate Medical University, School of Medicine, Morioka, Iwate 020-0023, Japan
Kaoru Ishida, Shusaku Sasaki, Masahiro Kojika, Akira Sasaki, Department of Surgery, Iwate Medical University, School of Medicine, Morioka, Iwate 020-0023, Japan
Shigeatsu Endo, Morioka Yuai Hospital, Morioka, Iwate 020-0834, Japan
Author contributions: Sato H, Kojika M, Endo S and Inoue Y designed the report; Ishida K, Sasaki S collected the patient’s clinical data; Sato H, Kojika M and Sasaki A wrote the paper.
Informed consent statement: The patients and their families were offered written explanations prior to the start of the treatment, and they provided consent.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Masahiro Kojika, MD, Department of Surgery, Iwate Medical University, School of Medicine, Morioka, Iwate 020-0023, Japan.
Telephone: +81-19-6515111 Fax: +81-19-6515151
Received: April 19, 2018
Peer-review started: April 19, 2018
First decision: May 30, 2018
Revised: June 17, 2018
Accepted: June 27, 2018
Article in press: June 27, 2018
Published online: July 28, 2018

Stent migration, which causes issues in stent therapy for esophageal perforations, can counteract the therapeutic effects and lead to complications. Therefore, techniques to regulate stent migration are important and lead to effective stent therapy. Here, in these cases, we placed a removable fully covered self-expandable metallic stent (FSEMS) in a 52-year-old man with suture failure after surgery to treat Boerhaave syndrome, and in a 53-year-old man with a perforation in the lower esophagus due to acute esophageal necrosis. At the same time, we nasally inserted a Sengstaken-Blakemore tube (SBT), passing it through the stent lumen. By inflating a gastric balloon, the lower end of the stent was supported. When the stent migration was confirmed, the gastric balloon was lifted slightly toward the oral side to correct the stent migration. In this manner, the therapy was completed for these two patients. Using a FSEMS and SBT is a therapeutic method for correcting stent migration and regulating the complete migration of the stent into the stomach without the patient undergoing endoscopic rearrangement of the stent. It was effective for positioning a stent crossing the esophagogastric junction.

Keywords: Self-expandable metallic stents, Esophageal perforation, Boerhaave syndrome, Endoscopy, Enteral nutrition

Core tip: Here, we report two cases of stent migrations that were managed using Sengstaken-Blakemore tubes, which prevented complete migration to the stomach. The correction of the stent position was easy, and did not require endoscopic guidance. By regulating the stents, nutrition management became possible through a nasoenteric feeding tube. Both patients were discharged after oral ingestion became possible.