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Self-expanding stent in the upper GI tract

Follow-up

It usually takes 2-3 days for the stent to fully expand to the optimal size. During this period, the patient will usually have increasing pain.

The patient is transferred immediately after the procedure as long as there are no complications. Normal hospital stay is 1-3 days.

The patient should be observed for:

  • pain – adequate pain medication should be administered.
  • respiration – serious breathing difficulty may be a sign of perforation in the esophagus.
  • creptiation (when air leaks to surrounding tissue) –  this is a sign of subcutaneous emphysema and can occur as a complication from perforation in the esophagus. 
  • rise in body temperature – this indicates a perforation in the esophagus.

An X-ray of the stent is performed to check that the contrast fluid passes the stent the first day after installation.

An X-ray might be taken of the stent before the patient starts to eat. Often, the patient can eat/drink until the X-ray is taken.

Complications from a self-expanding stent

Dislocation of the stent is rare, but still the most common complication.

In some cases, the tumor grows over the upper or lower edge. This requires a new stent to be placed partially in the old stent.

Stents which are placed through the cardia will make an opening from the stomach to the esophagus where there is risk of regurgitation of stomach content causing aspiration and pneumonia. There are stents available with an anti-reflux mechanism.

Abcesses can develop on the outside of the esophagus if the stent closes a fistula path from the inside without simultaneous drainage from the outside.

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