Estenosis esofágica por Histoplasma: manejo con prótesis metálica autoexpandible / Management of Esophageal Stenosis Due to Histoplasma with Self-expanding Metal Stents

Las estenosis esofágicas benignas son una causa común de consulta en los servicios de endoscopia y gastroenterología. Usualmente, dada su naturaleza no neoplásica, estas se han manejado con dilataciones endoscópicas a repetición, incómodas y costosas para el paciente, dada su constante repetición; además de tener siempre el riesgo de perforación esofágica en cada sesión. El uso de prótesis esofágicas para manejo de las estenosis esofágicas benignas viene en progresivo aumento con resultados prometedores para varias de las etiologías de este tipo de obstrucciones. Presentamos el caso de una estenosis esofágica benigna secundaria a infección por Histoplasma capsulatum, manejada con una prótesis metálica totalmente cubierta con resolución completa de la obstrucción.

Benign esophageal strictures are a common cause of medical consultation and gastroenterological endoscopy. Usually, given their non-neoplastic nature, they have been managed with recurrent endoscopic dilation which is uncomfortable for the patient and which generates high costs due repetition. In addition, there is always the risk of esophageal perforation at every session. The use of esophageal stents for management of benign esophageal strictures is becoming increasingly more common and is promising for various etiologies. We present a case of a benign esophageal stricture secondary to infection with histoplasma capsulatum which was managed entirely with a completely covered metal stent. This led to complete resolution of the obstruction.

Replacement of partial esophageal defect with pulmonary tissue with vascular pedicle / 中华胸心血管外科杂志

Objective: The purpose of our experiment is to use new type esophageal prosthesis, which is pulmonary tissue with vascular pedicle, to repair the partial esophageal defect. Methods: Twelve adult mongrel dogs were used for the study. Middle lobar bronchus of right lung was ligated and incised, so the pulmonary tissue with vascular pedicle was made. A 4 cm long and 1/2～2/3 circled esophageal wall, and full-thickness defect was created. The defect was patched by pulmonary tissue with vascular pedicle. Results: Seven dogs were put to death at planned times after the reconstructive operation. One dog is still alive without any problems for more than 12 months. One dog survived 38 days and then died of chronic empyema. The other three dogs died of anastomotic leak at 5～7 days after operation. The living dogs could be fed orally at seventh day after operation. Epithelization was found in the luminal surface of the defect. Conclusion: It was feasible that the partial esophageal defect was replaced by pulmonary tissue with vascular pedicle.

Non-surgical Treatment of Boerhaave's Syndrome with Esophageal Stent Insertion: 1 case report / 대한흉부외과학회지

Spontaneous esophageal perforation(Boerhaave's syndrome) is rare but associated mortality and morbidity are high and causes death in the absence of therapy. The diagnosis of Boerhaave's syndrome is very difficult, as a result, the delay significantly increases the complication rates. We experienced that a 54 year old man was treated by using successfully the flexible covered esophageal stent because of a very long delay diagnosis of esophageal perforation. He was discharged 3 days after the esophageal stent insertion. The post-stent insertion was an uncomplicated course and remained well on opd follow up.