Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2015; 21(3): 1032-1035
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.1032
Gastrotracheal fistula: Treatment with a covered elf-expanding Y-shaped metallic stent
Fei Wang, Hong Yu, Ming-Hui Zhu, Quan-Peng Li, Xian-Xiu Ge, Jun-Jie Nie, Lin Miao
Fei Wang, Hong Yu, Quan-Peng Li, Xian-Xiu Ge, Jun-Jie Nie, Lin Miao, Institute of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
Ming-Hui Zhu, Department of Gastroenterology, People’s Hospital of Jingjiang, Taizhou 214500, Jiangsu Province, China
Author contributions: Wang F and Yu H contributed equally to this work; all the authors contributed to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lin Miao, MD, Institute of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing 210011, Jiangsu Province, China. miaofrest@163.com
Telephone: +86-25-58509932 Fax: +86-25-58509931
Received: April 25, 2014
Peer-review started: April 27, 2014
First decision: May 29, 2014
Revised: June 27, 2014
Accepted: July 24, 2014
Article in press: July 25, 2014
Published online: January 21, 2015
Processing time: 269 Days and 23.7 Hours
Abstract

A 67-year-old man had a sev-ere cough and pulmonary infection for 1 wk before seeking evaluation at our hospital. He had undergone esophagectomy with gastric pull-up and radiotherapy for esophageal cancer 3 years previously. After admission to our hospital, gastroscopy and bronchoscopy revealed a fistulous communication between the posterior tracheal wall near the carina and the upper residual stomach. We measured the diameter of the trachea and bronchus and determined the site and size of the fistula using multislice computed tomography and gastroscopy. A covered self-expanding Y-shaped metallic stent was implanted into the trachea and bronchus. Subsequently, the fistula was closed completely. The patient tolerated the stent well and had good palliation of his symptoms.

Keywords: Gastrotracheal fistula; Y-shaped metallic stent; Esophageal cancer; Gastroesophageal surgery

Core tip: Gastrotracheal fistula (GTF), the fistula between the tracheobronchial tree and stomach after gastric pull-up surgery, is an extremely rare complication of esophagectomy and the condition is life-threatening. For these patients, the goal of therapy is palliative rather than curative. During the past decade, metallic airway stents have been used in patients with GTFs. However, fistulas close to the carina often require the placement of Y-shaped stents for successful palliation. We report a patient post-esophagectomy with a GTF near the carina that was successfully treated with a covered self-expanding Y-shaped metallic stent.