Endoscopy 2011; 43(5): 434-437
DOI: 10.1055/s-0030-1256075
Case Report/Series

© Georg Thieme Verlag KG Stuttgart · New York

Esophageal reconstitution by simultaneous antegrade/retrograde endoscopy: re-establishing patency of the completely obstructed esophagus

D.  Schembre1 , J.  B.  Dever2 , M.  Glenn1 , S.  Bayles1 , J.  Brandabur1 , R.  Kozarek1
  • 1Virginia Mason Medical Center – Gastroenterology, Seattle, Washington, USA
  • 2University of California at San Francisco – Gastroenterology, Fresno, California, USA
Further Information

Publication History

submitted 1 September 2010

accepted after revision 11 October 2011

Publication Date:
28 February 2011 (online)

Preview

Complete obstruction of the proximal esophagus is an uncommon complication of radiotherapy. Standard endoscopic dilation is not possible because no lumen exists. We describe a retrospective case series in which rendezvous endoscopy, tissue puncture, dilation, and stenting were used to restore function to a group of patients with complete esophageal obstruction. The series consisted of patients referred for complete esophageal obstruction after radiation therapy over 5 years. Ultimately, five patients underwent successful initial recanalization via rendezvous endoscopy. All patients were able to resume eating and four have been able to maintain oral alimentation with periodic dilation. One patient developed self-limited pneumomediastinum after needle puncture and cervical osteomyelitis after stenting, and another developed an anterior neck abscess after stenting. Rendezvous endoscopy can successfully treat complete esophageal obstruction resulting from radiation therapy. Temporary stenting may allow patients to swallow immediately and leave the hospital sooner but does not appear to reduce the need for subsequent dilation and may result in serious complications.

References

D. SchembreMD 

Swedish Gastroenterology

1221 Madison St. Suite 1220
Seattle, WA 98104

Email: Drew.Schembre@swedish.org