Mansoor MS, Tejada J, Parsa NA, Yoon E, Hida S. Off label use of lumen-apposing metal stent for persistent gastro-jejunal anastomotic stricture. World J Gastrointest Endosc 2018; 10(6): 117-120 [PMID: 29988884 DOI: 10.4253/wjge.v10.i6.117]
Corresponding Author of This Article
Muhammad Sohail Mansoor, MD, Academic Fellow, Department of Gastroenterology, Albany Medical Center, 43 New Scotland Ave, 4th Floor A405, Albany, NY 12047, United States. mansoom@amc.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jun 16, 2018; 10(6): 117-120 Published online Jun 16, 2018. doi: 10.4253/wjge.v10.i6.117
Off label use of lumen-apposing metal stent for persistent gastro-jejunal anastomotic stricture
Muhammad Sohail Mansoor, Juan Tejada, Nour A Parsa, Eric Yoon, Sven Hida
Muhammad Sohail Mansoor, Juan Tejada, Nour A Parsa, Eric Yoon, Sven Hida, Department of Gastroenterology, Albany Medical Center, Albany, NY 12047, United States
Author contributions: Mansoor MS, Tejada J and Yoon E designed the report; Mansoor MS, Parsa NA and Hida S performed the literature review; Mansoor MS, Tejada J and Hida S wrote the manuscript.
Informed consent statement: The patient involved in this study gave informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: All authors have no conflicts of interest to report.
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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Muhammad Sohail Mansoor, MD, Academic Fellow, Department of Gastroenterology, Albany Medical Center, 43 New Scotland Ave, 4th Floor A405, Albany, NY 12047, United States. mansoom@amc.edu
Telephone: +1-507-2615816 Fax: +1-518-2626470
Received: January 11, 2018 Peer-review started: January 12, 2018 First decision: March 7, 2018 Revised: March 30, 2018 Accepted: April 19, 2018 Article in press: April 19, 2018 Published online: June 16, 2018
ARTICLE HIGHLIGHTS
Case characteristics
Our patient’s main reported symptoms were weakness, fatigue and a 50-pound weight loss.
Clinical diagnosis
On esophagogastroduodenoscopy (EGD) patient was found to have a gastro-jejunal (GJ) anastomotic stricture.
Differential diagnosis
A careful endoscopic evaluation is necessary to exclude alternative diagnosis such as marginal ulcer and gastro-gastric fistula which can present with similar symptoms.
Laboratory diagnosis
Main laboratory testing for GJ anastomotic stricture involves checking for Helicobacter Pylori through hydrogen breath test, serology, stool antigen test or microscopic examination of obtained tissue during EGD.
Imaging diagnosis
No imaging techniques were used in diagnosis and management of this case though an upper gastrointestinal series can be performed to diagnosis GJ anastomotic stricture/stenosis.
Pathological diagnosis
No Helicobacter pylori organisms were found on microscopic examination of specimens obtained during EGD.
Treatment
Lumen apposing metal stent (LAMS) was deployed in GJ anastomotic stricture during EGD while patient was continued on daily proton pump inhibitor orally.
Term explanation
The term “Hydrogen-potassium ATPase inhibitor” mentioned in this case report is more commonly known as “proton pump inhibitor”.
Experiences and lessons
The newer LAMS is a safe and effective option for management of GJ anastomotic stricture and provides us with an alternative to fully covered self-expanding metal stent.
