Aorto-oesophageal fistula after oesophageal stent placement in a patient with a Roux-en-Y gastric bypass

Tc, Boerlage; Hs, Hermanides; De, Moes; Il, Tan; Gm, Houben; Acherman, Yaïr I. Z.

doi:10.1308/rcsann.2016.0226

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…An aorto-esophageal fistula was diagnosed at the site of the bump and treated with placement of an endovascular covered aortic stent. This case has earlier been published as a case report [ 9 ].…”

Section: Resultsmentioning

confidence: 98%

A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis

et al. 2018

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BackgroundStaple line leakage after bariatric surgery can be treated by endoscopic placement of a self-expandable stent. The success rate of stent placement is generally high, but migration is a frequent adverse event that hampers successful treatment. The Niti-S Beta stent is a fully covered double-bump stent that was specifically designed to prevent migration. This study aimed to evaluate the effectiveness and adverse event rate of the Niti-S Beta stent.MethodsA retrospective study was performed in three high-volume bariatric centers. All consecutive patients between 2009 and 2016 who underwent placement of a Beta stent for staple line leakage were included. Primary outcome was resolution of the leakage; secondary outcome was the adverse event rate including migration.ResultsThirty-eight patients were included. Twenty-five (66%) had resolution of the leakage. Success rate was higher in patients who were treated with implantation of a Beta stent as initial treatment (100%) than in patients who were treated with a stent after revisional surgery had failed (55%, p = 0.013). Migration occurred in 12 patients (32%). There were two severe adverse events requiring surgical intervention, including a bleeding from an aorto-esophageal fistula.ConclusionsThe success rate and the migration rate of the Beta stent seem comparable to other stents in this retrospective study. Despite the novel double-bump structure of the stent, the migration rate does not seem to be decreased.

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Section: Resultsmentioning

confidence: 98%

A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis

et al. 2018

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“…5 Additionally, TEVAR does not allow for concomitant esophageal resection or repair, which has been reported to improve long-term outcomes. 5 Boerlage et al 6 reported their experience with AEF after esophageal stent erosion which had been placed for complications of bariatric surgery. They used a Sengstaken-Blakemore tube in addition to TEVAR when the patient presented with severe hematemesis, and did not complete an open staged aortic repair.…”

Section: Discussionmentioning

confidence: 99%

Aortoesophageal fistula treated with staged aortic stent graft and subsequent homograft interposition

Dunphy

Ulloa

Benharash

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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Aortoesophageal fistula (AEF) is a rare complication of esophageal interventions. We present a 49-year-old woman who underwent Roux-en-Y gastric bypass with a recurrent gastrojejunal anastomotic leak requiring covered esophageal stent placement. She presented 1 month later with abdominal pain, leukocytosis, and hematemesis. A computed tomography scan demonstrated migration of the esophageal stent with aortic erosion concerning for AEF. She underwent emergent endovascular exclusion of an AEF to the descending thoracic aorta with subsequent esophageal resection and diversion and aortic endograft explant, resection, and homograft repair on postoperative day 6 allowing for staged removal of prosthetic material and maintenance of inline flow.

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“…The majority of patients had either minimally invasive procedures such as insertion of an esophageal stent for leakage or perforation, 12,27–31 or medical treatment for pneumonia, 32–34 bronchiectasis/lung abscess, 12,24,32,35 hypoxemia, 34,36 insertion of a pigtail catheter for drainage of pleural effusion, 32,37–40 or insertion of an aortic stent for aortoesophageal fistula. 41 Surgical intervention was performed in only a small number of patients ( n = 63). All of the operated patients had organic complications.…”

Section: Discussionmentioning

confidence: 99%

Thoracic complications in bariatric surgery patients

Arab

Alqannas²

2019

Asian Cardiovasc Thorac Ann

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Obesity is a health issue that can lead to medical and psychological problems. Recently, bariatric surgery has become the best choice for treatment of selected candidates. As the number of bariatric surgeries increases, various related postoperative complications are being encountered. Most studies have been concerned with abdominal complications and thoracic complications were beyond their scope. The aim of this report was to review thoracic complications following bariatric surgery, in terms of incidence, management, and outcome. A literature search of English language published data concerning thoracic complications related to or following bariatric surgery was performed in November 2018. A total of 10,145 results were found. After screening titles and abstracts, 10,060 noneligible publications were excluded. Eighty-five publications were potentially eligible and their full texts were analyzed. After excluding overlapping series of patients, 44 studies were selected. These included 934 patients. Females accounted for 87.9% of the included patients. Ages ranged between 21 and 64 years (mean 43.86 ± 4.4 years). Most frequently encountered complications were esophageal (80.84%) followed by pulmonary (17.45%). The majority of esophageal complications were functional (82.38%) in contrast to the pulmonary type that were mostly organic (87.73%). There were 5 documented deaths. We concluded that thoracic complications are not infrequent after bariatric surgery. Esophageal and pulmonary are the most common thoracic complications reported. The outcome is usually favorable. Mortality may be avoided when complications are detected early and well-managed.

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Aorto-oesophageal fistula after oesophageal stent placement in a patient with a Roux-en-Y gastric bypass

Cited by 9 publications

References 5 publications

A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis

A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis

Aortoesophageal fistula treated with staged aortic stent graft and subsequent homograft interposition

Thoracic complications in bariatric surgery patients

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