[Solving of complications arising during and after application self-expandible metallic stents in palliation of malignant dysphagia].

INTRODUCTION: During palliative treatment of malignant disphagia in inoperabile patients various and serious complications may occur and compromite the method of treatment if there were not solved. AIM: Goal is to present the most frequent complications due to esophageal stenting and the way of their solving. MATERIALS AND METHOD: From 1996. to 2009. in 237 patients (164 esophageal carcinoma, 33 carcinoma of the esophagogastric junction, 14 bronchial carcinoma, 7 esophagojejunal anastomosis, 9 esophageal fistulas) 245 stents have been placed (54 uncovered and 191 covered). Mean survival period was 14.7 months (ranged from 1 do 33 months). Esophageal perforation (1), stent migration (9), malignant tissue ingrowth (31) and overgrowth (24) have been revealed by barium contrast study during follow up. Perforation was solved by placing covered stent, migration by removing migrated stent endoscopically or surgically, ingrowth and overgrowth by balon dilating or restenting under the fluoroscopically guidance and control. CONCLUSION: One can expect and recognize complications regarding esophageal stenting because it is the only way for their sucsessfull treatment.

[Thoracic manifestations of gastrointestinal diseases].

Variety of gastrointestinal tract (GIT) changes that have their manifestation in thorax, disable their detailed review. Therefore, this article, represents short and overall over-view of these conditions. Standard chest x-ray can reveal esophageal disorders, herniation of abdominal organs into thorax, signs of GIT organs perforation, subphrenic abscess. Numerous diseases of intrabadominal organs of digestive tract can spread to the thorax, either per continuitatem or by lymphogenous or hemaotgenous dissemination. Therefore, chest x-ray is obliged by investigation of abdominal organs. If it is necessary additional diagnostic procedures are performed to confirm or exclude the association of lung or pleura features with GIT disorders. Above mentioned, just confirm that chest x-ray is first in algorithm of diagnostic procedures in these pathologic conditions. If there is any suspicion to conditions that require patients treatment, additional imaging methods like computerized tomography (CT), ultrasonography (US) and barium enema of digestive tract are necessary.