Esophageal perforation: Biliary self-expandable metal stent to the rescue!

Area of Science:

• Pediatric Gastroenterology
• Minimally Invasive Surgery
• Esophageal Disorders

Background:

• Esophageal perforation is a critical emergency requiring prompt management.
• Iatrogenic esophageal injury, often from endoscopic dilatation, is the most common cause in children.
• Surgical interventions carry high risks, and endoscopic stenting is limited in pediatrics due to accessory size issues.

Purpose of the Study:

• To report a successful case of managing pediatric esophageal perforation using a biliary self-expandable metal stent.
• To highlight the potential of endoscopic stenting in pediatric iatrogenic esophageal injuries.

Main Methods:

• A 22-month-old male with a history of tracheoesophageal fistula and multiple surgeries developed esophageal perforation during stricture dilation.
• The perforation was successfully treated using a biliary fully covered self-expandable metal stent.

Main Results:

• Successful management of esophageal perforation in a pediatric patient with a biliary stent.
• Demonstration of a minimally invasive treatment option for complex pediatric esophageal injuries.

Conclusions:

• Endoscopic stenting with biliary metal stents can be an effective treatment for iatrogenic esophageal perforation in pediatric patients.
• This approach may overcome limitations of standard endoscopic accessories in the pediatric population.