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Description
Temporary esophageal stents are an important and effective treatment for benign esophageal strictures, such as those caused by caustic ingestions. Fully covered self-expanding metal stents (FCSEMS) provide the benefit of continuous dilation pressure over longer periods of time compared to bougie or balloon dilation. However, stent migration is the most common complication and can be observed in up to 40% of patients, especially with FCSEMS and in refractory strictures. Typically, the stent is secured by using clips or suturing devices. However, we present a case where traditional methods of securing a stent were not possible due to the location of the stricture, and how we attempted to prevent migration using the dental floss method. The patient is an 18-year-old male with complex proximal esophageal stenosis secondary to caustic ingestion thar, at diagnosis measured 3mm diameter, 5cm in length, and was located 19cm from the incisors. The patient underwent 21 dilations within 7 months using different modalities. The last two were FCSEMS. The first stent could not be fixed with clips or sutures and migrated distally after 2 hours. For the second attempt, dental floss was tied to the proximal end of the stent before placement, and it was secured by threading through a nasogastric tube and taping to the side of the face. This allowed the stent to stay in place for 30 hours before it also migrated distally. We propose that this type of strategy Is useful in cases where stent placement does not allow for traditional methods like clipping and suturing, and could be more effective if attached to two sides of the proximal end of the stent.
Publication Date
11-2024
Disciplines
Gastroenterology | Pediatrics
When and Where Presented
Presented at the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN) Annual Meeting; Hollywood, FL; November 6-9, 2024.
Recommended Citation
Colon Guzman, Sofia; Ibrahimi, Nadia; and Krasaelap, Amornluck, "Preventing Migration Of Esophageal Silicone Covered Self-Expanding Metal Stent Using Dental Floss In A Pediatric Patient" (2024). Presentations. 100.
https://scholarlyexchange.childrensmercy.org/presentations/100
