Migration of a self expandable metallic stent in malignant esophageal-pleural fistula - A complication that needs active surveillance

Abstract

Development of malignant esophago-pleural fistulas is relatively rare but life-threatening complication. We present a 50 year-old female patient with 6 months history of distal esophageal carcinoma.  Patient presented with right sided chest pain, dysphagia, dyspnoea, cough and fever. Right side pyopneumothorax was diagnosed and intercostal drainage (ICD) tube was inserted. Presence of food material in the drainage bag led to the diagnosis of oesophageal-pleural fistula. Self expandable stent was placed, however 1 month later stent migration was observed and patient expired due to worsening pyopneumothorax and sepsis.