PMC3271698_01
Right posterior oblique spot radiograph during esophogram shows obliterating stricture at the pharyngo-esophageal junction. Contrast material extravasated into the soft tissues of the anterior right neck and through the tracheostomy stoma
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F1
In addition, separate tracheoesophageal and pharyngo-cutaneous fistulae were demostrated [Figure 1a]. The stent was deployed 14-23 cm from the incisors [Figure 1b]. Repeat barium swallow at 3 and 7 months showed a patent stent with no leak or migration [Figure 1c]. He returned 14 months later; repeat endoscopy was performed under general anesthesia and the stent removed successfully using the double-channel therapeutic endoscope and a rat tooth forceps [Figure 1d]. Repeat barium swallow confirmed the absence of leakage [Figure 1e], and the patient tolerated oral intake without dysphagia, choking, or leakage through the cervical soft tissues.
PMC3271698_02
Endoscopic view of the stent at the level of hypopharynx
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F2
Barium swallow showed a pharyngo-tracheal fistula [Figure 2a]. Repeat endoscopy and contrast esophagogram showed proximal stent margin located at the base of the tongue [Figures 2b and 2c] and the fistula sealed completely. Repeat barium swallow showed complete occlusion of the fistula [Figure 2d].
PMC3271698_03