[Management of postoperative ischemic jejunal stenosis using balloon dilatation and/or Wallstent implant]

Ischaemic stenosis of the jejunum is rare. For technical, anatomical, and pathological reasons ischemic stenosis of the jejunal segment used for the replacement of the stomach and oesophagus requires a special approach. The present study reports two cases of dilation of ischaemic strictures of the jejunal loop by balloon catheter, used for replacement after oesophagogastrectomy and gastrectomy. In the later case, in which the occlusion of the blood vessels supplying the affected segment was observed right at the level of the aorta, Wallstent was implanted. The advantages and disadvantages of metal stents are discussed and oesophaogoaortic fistula, a rare complication, which appeared a year after Wallstent placement, is described. The two cases presented in this study give evidence that using balloon catheters and implanting Wallstent-in selected cases-may give good results in the management of postoperative ischaemic strictures of the jejunum. The minimally invasive technique with the special indications described here is not known to have been used so far. The rare complication mentioned, however, requires special attention.