MASSIVE HEMORRHAGE CAUSED BY A PERFORATING GIANTURCO-Z STENT RESULTING IN AN AORTOESOPHAGEAL FISTULA

Endoscopic placement of self-expanding metal stents is regarded as a s afe and effective method of palliating obstructive esophageal malignan cies, We report here the case of a 49-year-old woman with an inoperabl e squamous-cell carcinoma located in the mid-esophagus, After two cour ses of chemotherapy, a silicone-covered Gianturco-Z stent was placed b ecause of progressive tumor growth, Eighteen days after the stent plac ement, the patient presented with hematemesis, and died 24 hours after admission. At autopsy, the proximal end of the stent was found to hav e perforated through the normal esophageal mucosa into the aorta, resu lting in an aortoesophageal fistula, This complication should be consi dered in patients who present with massive hemorrhage after undergoing radiotherapy or chemotherapy. or both, before stent placement in the mid-esophagus.