Esophageal perforation due to metallic stent in a pediatric patient: clinical case report
DOI:
https://doi.org/10.47464/MetroCiencia/vol34/3/2026/87-94Keywords:
esophageal perforation, metallic stent, esophageal atresia, tracheoesophageal fistula, pediatricsAbstract
Esophageal complications associated with metallic stents in pediatric patients are uncommon but may be severe. An 8-year-old boy with type C esophageal atresia repaired during the neonatal period and refractory anastomotic stricture experienced sequential and nearly continuous exposure to six metallic stents for at least 430 days. Six devices were identified: two 16 × 20 mm lumen-apposing metal stents, two 10 Fr × 40 mm biliary stents, and two esophageal stents measuring approximately 18 mm. Dwell times ranged from 15 to 169 days. During follow-up, stent migration, persistent stricture, esophagotracheal or esophagobronchial fistulas, and esophageal injury with multiple microperforations were documented. The patient developed respiratory failure and severe aspiration pneumonia requiring intensive care. Management included stent removal, endoscopic vacuum therapy, and cervical esophagostomy for salvage. Subsequently, reconstruction was performed using retrosternal colonic interposition with esophagocolonic and cologastric anastomoses. The temporal sequence, repeated and prolonged exposure, and biological plausibility support a probable association between the stent-based strategy and esophageal injury, without establishing definitive causality. This case highlights the importance of device traceability, endoscopic surveillance, and early reassessment of prolonged stent-based strategies in previously operated pediatric esophagi, particularly when complications or persistent symptoms develop, and emphasizes the need for multidisciplinary management and timely reconstructive planning.
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Copyright (c) 2026 Lenin Chachapoya-Rivas, Juliors Francisco Gonzalez-Navarro, Daniel Benigno Acosta-Farina
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